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. 2025 Jun 23;11(3):00709-2024.
doi: 10.1183/23120541.00709-2024. eCollection 2025 May.

Severe Paediatric Asthma Collaborative in Europe: real-world data on children on biologics

Norrice M Liu  1 , Mariëlle W Pijnenburg  2 , Antoine Deschildre  3 , Ines de Mir-Messa  4 , Sigve Adalen  5 , Flore Amat  6 , Luna Antonino  7 , Priscille Biermé  8 , Maynor Bravo-Lopez  4 , Karin C L Carlsen  5   9 , Silvia Carraro  10 , Pierrick Cros  11 , Celine Delestrain  12 , Carolina Diaz Garcia  13 , Ralph Epaud  2 , Grazia Fenu  14 , Valentina A Ferraro  10 , Louise Fleming  15 , Laurence Hanssens  16 , Anouk Heine  2 , Géraldine Labouret  17 , Maria-Chiara Leoni  12 , Amelia Licari  18 , Enrico Lombardi  14 , Alejandro Lopez Neyra  19 , Christophe Marguet  20 , Julie Mazenq  21 , Santiago Pérez Tarazona  22 , Juan Carlos Ramos Díaz  23 , Cyril Schweitzer  24   25 , Elena Spada  26 , José Valverde Molina  13 , Stijn Verhulst  7   27 , Stéphanie Wanin  28 , Franca Rusconi  29
Affiliations

Severe Paediatric Asthma Collaborative in Europe: real-world data on children on biologics

Norrice M Liu et al. ERJ Open Res. .

Abstract

Introduction: Real-world data on children with severe asthma is scarce. We report characteristics of children with severe asthma already on biologics, enrolled in the Severe Paediatric Asthma Collaborative in Europe, a clinical research collaboration of the European Respiratory Society.

Methods: We describe patient's characteristics including asthma control assessed with Global Initiative for Asthma (GINA) criteria, composite asthma severity index (CASI), exacerbations, unscheduled medical attendances, lung function and quality of life in children on biologic treatment because of severe asthma. We also assessed previous biologics use. Forced expiratory volume in 1 s, CASI, GINA, Paediatric Asthma Quality of Life Questionnaire score, exacerbations, unscheduled medical attendance and hospital admission comparisons in patients treated with different biologics were adjusted by age, sex and biologic therapy duration.

Results: Among the 250 children (median age 13.2 years) recruited, 56.8% used omalizumab, 21.6% mepolizumab and 21.6% dupilumab. At enrolment, the dupilumab group was older (median 15.0 years), while the omalizumab group had been on biologic treatment the longest (median 622 days). Overall, 27% and 8% had partly controlled and uncontrolled asthma respectively, according to GINA. In the last 12 months, 52% and 29% had at least one and two exacerbations, respectively; airflow obstruction was found in 33%. 10% were admitted to hospital due to exacerbation. A previous switch from another biologic was recorded in 16%, predominantly due to nonresponse.

Conclusions: Most children on biologics obtained good symptom control, but many still experienced asthma attacks. Switching between biologics was substantial. There is still an unmet need in severe paediatric asthma.

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Conflict of interest statement

Conflict of interest: N.M. Liu, S. Adalen, L. Antonino, M. Bravo-Lopez, S. Carraro, C. Delestrain, V.A. Ferraro, L. Hanssens, A. Heine, G. Labouret, M-C. Leoni, A. Licari, J. Mazenq, S. Pérez Tarazona, J.C. Ramos Díaz, E. Spada and F. Rusconi declare no conflicts of interest. Conflict of interest: M.W. Pijnenburg has received consulting fees from Sanofi and support from the ERS; she is on a data safety monitoring board for Novartis, she is involved in studies of AstraZeneca and Sanofi, and was the head of the ERS Paediatric Assembly (2020–2023). A. Deschildre has received consulting fees and payments from Novartis, GSK, Sanofi, Regeneron, AstraZeneca, Aimmune Therapeutics, Nestlé Health Science, ALK, Stallergènes-Greer, ALK, DBV Technologies and Viatris; he is on the Data Safety Monitoring Board for the BOOM study. I. de Mir-Messa has received consulting fees from GSK, Sanofi and Gebro. Flore Amat has received consulting fees, payments and support from Stallergènes-Greer, AImmune Therapeutics, GSK, Novartis, Sanofi, DBV and ALK; she is the principal investigator for research studies supported by Sanofi and AstraZeneca. Priscille Biermé has received payments from Sanofi, AstraZeneca, ALK, Stallergènes-Greer and Novalac; she is on the advisory boards for Sanofi and AstraZeneca. K.C.L. Carlsen has received honoraria from Thermo Fisher Scientific. P. Cros has received support from Sanofi. C. Diaz Garcia has received payments and support from GSK, Sanofi and Faes, and is the secretary of the Spanish Society of Paediatric Pulmonology. R. Epaud has received consulting fees and payments from AstraZeneca and GSK; he is on the advisory boards for AstraZeneca, Novartis and Sanofi. G. Fenu has received payment and support from AstraZeneca, GSK, Novartis and Sanofi. L. Fleming has received consulting fees and payments from AstraZeneca, Sanofi, GSK and Regeneron. E. Lombardi has received grants from Boehringer, Restech and Sanofi; and payments and support from AlfaSigma, Angelini, Chiesi, Deca and Lusofarmaco; he has received research equipment from Cosmed and Restech; and he is on the advisory boards for GSK and Sanofi. A. Lopez Neyra has received payments and support from Novartis, GSK, Sanofi and AstraZeneca. C. Marguet has received consulting fees, payments and support from Sanofi, Novartis and AstraZeneca; he is the head of the French Cystic Fibrosis Society, and is on the scientific committee of the French Allergy Pulmonology Society. J. Valverde Molina has received payments and support from GSK, AstraZeneca, Sanofi and Gebro; he is the president of the Severe Asthma Association of the Region of Murcia, Spain. C. Schweitzer has received consulting fees, payment and support from MSD Laboratory, AstraZeneca, Sanofi; and was the president of the French Society of Pediatric Pneumology and Allergology (2019–2023). S. Verhulst has received consulting fees from Sanofi. S. Wanin has received grants, consulting fees, payments and support from GSK, AstraZeneca, Sanofi, ALK and Stallergènes-Greer.

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