Challenges and choices in the pharmacological treatment of non-severe pediatric asthma: A commentary for the practicing physician

In recent years, asthma research has focused intensely on the severe part of the disease spectrum, leading to new treatments, mostly therapeutic monoclonal antibodies. However, severe asthma accounts for not more than 2% of asthma in the pediatric population. Therefore, non-severe asthma remains a m...

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Bibliographic Details
Published in:The World Allergy Organization journal 2019-09, Vol.12 (9), p.100054-100054, Article 100054
Main Authors: Kalayci, Omer, Abdelateef, Hanan, Pozo Beltrán, César Fireth, El-Sayed, Zeinab A., Gómez, René Maximiliano, Hossny, Elham, Morais-Almeida, Mário, Nieto, Antonio, Phipatanakul, Wanda, Pitrez, Paulo, Wong, Gary Wk, Xepapadaki, Paraskevi, Papadopoulos, Nikolaos G.
Format: Article
Language:English
Subjects:
Age groups
Allergies
Asthma
Hay fever
Inflammation
Medical personnel
Pediatrics
Preschool children
Rhinitis
Steroids
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Summary:In recent years, asthma research has focused intensely on the severe part of the disease spectrum, leading to new treatments, mostly therapeutic monoclonal antibodies. However, severe asthma accounts for not more than 2% of asthma in the pediatric population. Therefore, non-severe asthma remains a major health problem in children, not only for patients and parents but also for healthcare professionals such as general practitioners, pediatricians and allergists who take care of these patients. It is thus essential to identify and put in context novel concepts, applicable to the treatment of these patients. Recent evidence suggests benefits from using anti-inflammatory treatment even for the mildest cases, for whom until now only symptomatic bronchodilation was recommended. Likewise, “reliever” medication may be better combined with an inhaled corticosteroid (ICS). Among “new” treatments (for children), ICS formulation in ultrafine particles has showed promise and tiotropium is gaining access to the pediatric population. Maintenance and reliever therapy (MART) is an option for moderate disease. Most importantly, personalized response to medications appears to be considerable, therefore, it may need to be taken into account. Overall, these new options provide opportunities for multiple new management strategies. The deployment of such strategies in different populations remains to be evaluated.
ISSN:1939-4551
1939-4551
DOI:10.1016/j.waojou.2019.100054