New perspectives of childhood asthma treatment with biologics

被引:33
作者
Just, Jocelyne [1 ,2 ]
Deschildre, Antoine [3 ]
Lejeune, Stephanie [3 ]
Amat, Flore [1 ,2 ]
机构
[1] Hop Enfants Armand Trousseau, AP HP, Dept Allergol, Ctr Asthme & Allergies, Paris, France
[2] Sorbonne Univ, Equipe EPAR, INSERM, Inst Pierre Louis Epidemiol & Sante Publ,UMR S 11, Paris, France
[3] Univ Nord France, CHU Lille, Pediat Pulmonol & Allergy Dept, Hop Jeanne de Flandre, Lille, France
关键词
QUALITY-OF-LIFE; DOUBLE-BLIND; ALLERGIC-ASTHMA; INHALED CORTICOSTEROIDS; PERSISTENT ASTHMA; ANTI-IGE; OMALIZUMAB; CHILDREN; SAFETY; DUPILUMAB;
D O I
10.1111/pai.13007
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Asthma is no longer considered as a single disease but rather as a syndrome corresponding to different entities and pathophysiologic pathways. A targeted strategy is part of personalized medicine which aims to better define each patient's phenotype and endotype so as to prescribe the most suitable treatment at an individual level. Omalizumab and, more recently, mepolizumab are the first biologics approved for children (6-18 years). Omalizumab is now widely used to treat severe allergic asthma in children and is highly effective for asthma exacerbations and asthma control with a good safety profile. Moreover, several other drugs-lebrikizumab, dupilumab, tezepelumab, mepolizumab, reslizumab, benralizumab-are used or are being studied in both teenagers and adults and could benefit younger children in the near future. We hypothesize that defining the asthma phenotype/endotype regarding the type and intensity of inflammation, association with allergic or non-allergic comorbidities, and airway remodeling should contribute to the choice of a specific biologic. Pediatric specificities have to be addressed and validated by studies in children. Long-term effectiveness and particularly the impact on the natural history of asthma should also be investigated. Severe asthma in children is a complex disease, and patients have to be referred to a specialized pediatric asthma center to confirm diagnosis and initiate the best treatment strategy which could include biologics while taking into account their high cost.
引用
收藏
页码:159 / 171
页数:13
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