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Review
. 2019 Feb;30(1):7-16.
doi: 10.1111/pai.12990. Epub 2018 Nov 15.

Pediatric asthma: An unmet need for more effective, focused treatments

Nikolaos G Papadopoulos  1   2 , Adnan Čustović  3 , Michael D Cabana  4 , Sharon D Dell  5 , Antoine Deschildre  6 , Gunilla Hedlin  7   8 , Elham Hossny  9 , Peter Le Souëf  10 , Paolo M Matricardi  11 , Antonio Nieto  12 , Wanda Phipatanakul  13 , Paulo M Pitrez  14 , Petr Pohunek  15 , Marcela Gavornikova  16 , Xavier Jaumont  16 , David B Price  17   18
Affiliations
Review

Pediatric asthma: An unmet need for more effective, focused treatments

Nikolaos G Papadopoulos et al. Pediatr Allergy Immunol. 2019 Feb.

Abstract

Background: Despite remarkable advances in our understanding of asthma, there are still several unmet needs associated with the management of pediatric asthma.

Methods: A two-day, face-to-face meeting was held in London, United Kingdom, on October 28 and 29, 2017, involving a group of international expert clinicians and scientists in asthma management to discuss the challenges and unmet needs that remain to be addressed in pediatric asthma.

Results: These unmet needs include a lack of clinical efficacy and safety evidence, and limited availability of non-steroid-based alternative therapies in patients <6 years of age. An increased focus on children is needed in the context of clinical practice guidelines for asthma; current pediatric practice relies mostly on extrapolations from adult recommendations. Furthermore, no uniform definition of pediatric asthma exists, which hampers timely and robust diagnosis of the condition in affected patients.

Conclusions: There is a need for a uniform definition of pediatric asthma, clearly distinguishable from adult asthma. Furthermore, guidelines which provide specific treatment recommendations for the management of pediatric asthma are also needed. Clinical trials and real-world evidence studies assessing anti-immunoglobulin E (IgE) therapies and other monoclonal antibodies in children <6 years of age with asthma may provide further information regarding the most appropriate treatment options in these vulnerable patients. Early intervention with anti-IgE and non-steroid-based alternative therapies may delay disease progression, leading to improved clinical outcomes.

Keywords: asthma management; omalizumab; pediatric asthma; unmet need.

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Conflict of interest statement

Adnan Čustović reports personal fees from Novartis, Regeneron/Sanofi, ALK, Bayer, ThermoFisher, GlaxoSmithKline, and Boehringer Ingelheim. Antoine Deschildre reports personal fees from Novartis, DBV, AImmune, and TEVA and personal fees and congress invitations from ALK, Stallergenes Greer, GlaxoSmithKline, AstraZeneca, and Chiesi. Antonio Nieto reports grants and personal fees from Novartis; clinical trial support from GlaxoSmithKline and AstraZeneca; and lecture honoraria from ThermoFisher. David B. Price reports personal fees from Almirall, Amgen, Cipla, GlaxoSmithKline, Kyorin, Merck, Skyepharma and grants from AKL Research and Development Ltd, British Lung Foundation, Respiratory Effectiveness Group, and UK National Health Service. He reports grants and personal fees from Aerocrine, AstraZeneca, Boehringer Ingelheim, Chiesi, Mylan, Mundipharma, Napp, Novartis, Pfizer, Teva, Theravance, and Zentiva and non‐financial support from the Efficacy and Mechanism Evaluation program and Health Technology Assessment. Dr Price has stock/stock options from AKL Research and Development Ltd which produces phytopharmaceuticals, and owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 74% of Observational and Pragmatic Research Institute Pte Ltd (Singapore). Gunilla Hedlin reports advisory board participation with Novartis, AstraZeneca and ThermoFisher and lecture honoraria from ThermoFisher. Marcela Gavornikova and Xavier Jaumont are full‐time employees of Novartis Pharma AG, Basel, Switzerland. Michael D. Cabana reports personal fees from Novartis, Genentech, and ThermoFisher. Nikolaos G. Papadopoulos reports personal fees from Novartis, Faes Farma, Biomay, HAL, Nutricia Research, Menarini, MEDA, MSD, Omega Pharma, Abbvie, and Danone and grants from Menarini. Paulo M. Pitrez reports personal fees from Novartis, Boehringer Ingelheim, and AstraZeneca. Petr Pohunek reports personal fees and non‐financial support from Novartis, grants and personal fees from Teva, and personal fees from AstraZeneca and ALK. Sharon D. Dell reports personal fees from Trudell Medical International, AstraZeneca Canada, Novartis Pharmaceuticals, and Vertex Pharmaceuticals. Paolo M. Matricardi reports personal fees and grants from Novartis. All international expert clinicians and scientists received honoraria from Novartis for participation at the advisory board which led to the development of this manuscript.

Figures

Figure 1
Figure 1
Present inadequacies and potential future realities of pediatric asthma management
See this image and copyright information in PMC

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