New insights into the treatment of severe asthma in children. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Giovannini-Chami, Lisa; Albertini, Marc; Scheinmann, Pierre; de Blic, Jacques
• Is Part Of: Paediatric respiratory reviews. Volume 16:Issue 3(2015)
• Page Start: 167
• Page End: 173
• Publication Date: 2015-06
• Subjects: ATS American Thoracic Society -- ERS European Respiratory Society -- GINA Global Initiative for Asthma -- ACT asthma control test -- FEV1 forced expiratory volume in one second -- FeNO fraction of exhaled nitric oxide -- BMPRII bone morphogenetic protein receptor type II -- GLCCI1 glucocorticoid-induced transcript 1 -- GRα glucocorticoid receptor α -- GRβ glucocorticoid receptor α -- GRE glucocorticoid-responsive elements -- HDAC2 histone deacetylase 2 -- IL- interleukin -- ADRB2 adrenoceptor beta 2 -- LABA long-acting beta-agonist -- LTRA leukotriene receptor antagonist -- ICS inhaled corticosteroid -- HFA hydrofluoroalkane -- MMAD mass median aerodynamic diameter -- CIC ciclesonide -- BUD budesonide -- FLUT fluticasone propionate -- PEF peak expiratory flow -- MAPK mitogen-activated protein kinases -- Nrf2 nuclear erythroid 2-related factor 2 -- COPD chronic obstructive pulmonary disease -- SAL salmeterol -- ICAM-1 intercellular adhesion molecule 1 -- FDA Food and Drug Administration -- EMA European Medicines Agency -- TSLP thymic stromal lymphopoeitin -- NEJM New England Journal of Medicine -- AQLQ Asthma Quality of Life Questionnaire -- DREAM study Mepolizumab for severe eosinophilic asthma -- IFN- interferon -- AZISAST study Azithromycin for prevention of exacerbations in severe asthma -- RSV respiratory syncitial virus -- AIR study Asthma Intervention Research -- HRQL health-related quality of life; Innovative therapies -- Inhaled corticosteroids -- Bronchodilators -- Anti-cytokine -- Omalizumab -- Antiviral drugs; Pediatric respiratory diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory Therapy -- Periodicals; Child -- Periodicals; Appareil respiratoire -- Infections, chez l'enfant -- Périodiques; Appareil respiratoire -- Maladies, chez l'enfant -- Périodiques; 618.922
• DOI: 10.1016/j.prrv.2014.07.006
• Languages: English
• ISSNs: 1526-0542

Abstract

Summary: Severe asthma accounts for 0.5% of the general paediatric population and 4.5% of children with asthma, representing the major burden of asthma-health-care-associated costs. After ensuring a diagnosis of asthma and excluding difficult-to-treat patients with co-morbidities and non-adherence profiles, there remains children with real therapy-resistant asthma for whom the recommendations are to treat beyond guidelines. We describe new insights into the treatment of severe asthma in children, regarding both "classic drugs" (corticosteroids, bronchodilators) and innovative biological therapies targeting airway inflammation and impaired innate immunity. All of these new avenues remain to be studied and validated in children and will require fine clinical and biological phenotyping.