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Pediatr Allergy Immunol. 2019 Feb;30(1):7-16. doi: 10.1111/pai.12990. Epub 2018 Nov 15.

Pediatric asthma: An unmet need for more effective, focused treatments.

Author information

1
Division of Infection, Inflammation & Respiratory Medicine, The University of Manchester, Manchester, UK.
2
The Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian, University of Athens, Athens, Greece.
3
Department of Paediatrics, Imperial College London, London, UK.
4
Departments of Pediatrics and Epidemiology and Biostatistics, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
5
Division of Respiratory Medicine, Department of Pediatrics, Child Health Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
6
CHU Lille, Pediatric Pulmonology and Allergy Unit, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France.
7
Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.
8
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
9
Pediatric Allergy and Immunology Unit, Children's Hospital Ain Shams University, Cairo, Egypt.
10
School of Paediatrics and Faculty of Child Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.
11
Department of Pediatric Pneumology & Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
12
Pediatric Pulmonology & Allergy Unit, Children's Hospital La Fe, Valencia, Spain.
13
Pediatric Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts.
14
School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
15
Pediatric Department, 2nd Faculty of Medicine, Charles University Prague, and University Hospital Motol, Prague, Czech Republic.
16
Novartis Pharma AG, Basel, Switzerland.
17
Observational and Pragmatic Research Institute, Singapore, Singapore.
18
University of Aberdeen, Aberdeen, UK.

Abstract

BACKGROUND:

Despite remarkable advances in our understanding of asthma, there are still several unmet needs associated with the management of pediatric asthma.

METHODS:

A two-day, face-to-face meeting was held in London, United Kingdom, on October 28 and 29, 2017, involving a group of international expert clinicians and scientists in asthma management to discuss the challenges and unmet needs that remain to be addressed in pediatric asthma.

RESULTS:

These unmet needs include a lack of clinical efficacy and safety evidence, and limited availability of non-steroid-based alternative therapies in patients <6 years of age. An increased focus on children is needed in the context of clinical practice guidelines for asthma; current pediatric practice relies mostly on extrapolations from adult recommendations. Furthermore, no uniform definition of pediatric asthma exists, which hampers timely and robust diagnosis of the condition in affected patients.

CONCLUSIONS:

There is a need for a uniform definition of pediatric asthma, clearly distinguishable from adult asthma. Furthermore, guidelines which provide specific treatment recommendations for the management of pediatric asthma are also needed. Clinical trials and real-world evidence studies assessing anti-immunoglobulin E (IgE) therapies and other monoclonal antibodies in children <6 years of age with asthma may provide further information regarding the most appropriate treatment options in these vulnerable patients. Early intervention with anti-IgE and non-steroid-based alternative therapies may delay disease progression, leading to improved clinical outcomes.

KEYWORDS:

asthma management; omalizumab; pediatric asthma; unmet need

PMID:
30312503
DOI:
10.1111/pai.12990

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