Management of Severe Asthma in Children

• Published in: Current treatment options in pediatrics 2018-12, Vol.4 (4), p.438-455
• Main Authors: Lin, Nancy Y., Guilbert, Theresa W.
• Format: Article
• Language: English
• Subjects: Absenteeism; Allergens; Asthma; Behavior modification; Children & youth; Clinical trials; Congenital diseases; Costs; Critical Care Medicine; Cystic fibrosis; Disease; Drug administration; Education; Family Medicine; Gastroesophageal reflux; General Practice; Health services utilization; Immunoglobulins; Infections; Inhalers; Intensive; Maternal and Child Health; Medicine; Medicine & Public Health; Multidisciplinary teams; Patient compliance; Pediatrics; Pollutants; Pulmonary (RP Boesch; Quality of life; section editor; Spirometry; Steroids; Tomography; Topical Collection on Pulmonary
• ISSN: 2198-6088; 2198-6088
• DOI: 10.1007/s40746-018-0143-y

Purpose of review Severe asthma is a highly heterogeneous disorder associated with significant morbidity. The management of severe asthma in children is multifaceted and complicated by psychosocial factors, difficulties and barriers to medication adherence, difficulties of medication delivery, and comorbid diseases. This article aims to review the approach to the management of childhood severe asthma and examine the recent literature in the advances in phenotype-directed management of severe asthma in children. Recent findings Recently, more focus has been placed on the development of multidisciplinary clinics, school medication management programs, home management programs, and other interventions in order to optimize asthma management and care. Furthermore, there has been a shift in the paradigm of asthma management in children towards phenotype-directed management, especially in children with severe difficult-to-control or treatment-resistant asthma. Summary Current treatment of pediatric severe asthma includes three approved targeted biologic phenotype-directed therapies. There are some targeted therapies that are approved for adults which may prove to be beneficial in children with asthma as ongoing research continues. Further investigation into identifying predictors of treatment response and biomarkers that can lead to precision and personalized management for children with severe asthma is ongoing and will be imperative in determining the optimal treatment strategies for pediatric severe asthma.