| Title: | Expert meeting report : towards a joint European roadmap to address the unmet needs and priorities of paediatric asthma patients on biologic therapy |
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| Authors: | ID Golebski, Kornel (Author)
ID Potočnik, Uroš (Author), et al. |
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| Files: |  RAZ_Golebski_Kornel_2021.pdf (695,54 KB)
MD5: 192A612B9DC5F2AF57C4A16B6D3EFFEE
 https://doi.org/10.1183/23120541.00381-2021
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| Language: | English |
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| Work type: | Scientific work |
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| Typology: | 1.02 - Review Article |
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| Organization: | MF - Faculty of Medicine
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| Abstract: | Biologics use in severe paediatric asthma
The global prevalence of severe asthma among adolescents ranges from 4% to 11%; and up to 7% of children with asthma display an uncontrolled and severe form that is often associated with a substantial burden on the quality of life of patients and their families, and increasing costs of healthcare [1, 2]. “Childhood asthma” is an umbrella term describing a heterogeneous disease comprising different phenotypes and a wide range of symptoms [3–5].
Despite decades of basic and clinical research, tailored strategies to modify the natural course of asthma, prevent severe exacerbations and inhibit lung function decline are still lacking. In addition, clinical phenotypes are only moderately reliable in the prediction of treatment responses and our current understanding of asthma endotypes is limited. Most asthma endotypes involve concomitant inflammatory pathways and distorted immune parameters. Advances in understanding severe paediatric asthma pathophysiological mechanisms and immunological pathways mediating the airway inflammation would allow better characterisation of these patients as well as optimised intervention, guided by treatable traits and biomarkers [6, 7].
Recent studies have demonstrated the effectiveness of monoclonal antibodies (mAbs), also known as biologics, targeting type 2 inflammation in controlling the symptoms of severe asthma. Currently, four human mAbs are approved for use in children: mAbs that target interleukin (IL)-5 or IL-5 receptor (R) (mepolizumab and benralizumab), mAbs that target IL-4R (dupilumab), and mAbs that target immunoglobulin E (omalizumab). Omalizumab was the first biologic approved to treat moderate-to-severe allergic asthma (≥6 years of age). Mepolizumab and dupilumab have been approved for severe eosinophilic asthma (≥6 and ≥12 years of age, respectively), while benralizumab has been approved in the USA to treat children (≥12 years of age) with severe eosinophilic asthma [8–13].
The introduction of mAb agents in asthma treatment is a milestone in the application of personalised medicine. However, comparative studies and standardised algorithms for the management of paediatric severe asthma to guide the best therapeutic option for paediatric patients with severe asthma are lacking [14]. More personalised medicine approaches may benefit the patient by better matching patients with the most appropriate therapy. Risk stratification, remote monitoring and the integration of multiple data sources could help tailor management for the individual child with severe asthma.
A digital multidisciplinary European expert meeting took place on 9 July 2020. In this workshop, we brought together European respiratory/allergy paediatricians, immunologists, epidemiologists and basic scientists to identify the unmet needs of paediatric severe asthma patients, and set the priorities for clinical and research activities ahead. The participants discussed ongoing initiatives and knowledge gaps, and formulated proposals on how to address these challenges. In this report, we describe the main findings of this expert meeting. |
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| Keywords: | asthma, paediatric asthma, severe asthma, children, biologics, monoclonal antibodies, biologic therapy, therapy |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Submitted for review: | 07.06.2021 |
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| Article acceptance date: | 28.07.2021 |
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| Publication date: | 01.11.2021 |
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| Publisher: | European Respiratory Society |
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| Year of publishing: | 2021 |
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| Number of pages: | Str. 1-6 |
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| Numbering: | Letn. 7, Št. 4 |
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| PID: | 20.500.12556/DKUM-89852  |
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| UDC: | 616.2 |
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| ISSN on article: | 2312-0541 |
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| COBISS.SI-ID: | 84857091 |
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| DOI: | 10.1183/23120541.00381-2021 |
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| Publication date in DKUM: | 14.08.2024 |
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| Views: | 250 |
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| Downloads: | 13 |
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| Metadata: |    |
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| Categories: | Misc.
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