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Newer Treatments in the Management of Pediatric Asthma

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Abstract

Asthma control remains a significant challenge in the pediatric age range in which ongoing loss of lung function in children with persistent asthma has been reported, despite the use of regular preventer therapy. This has important implications for observed mortality and morbidity during adulthood. Over the past decade, there has been an emergence of other treatment adjuncts, such as anti-Immunoglobulin E (IgE)-directed therapy, low dose theophylline, and the use of macrolide antibiotics, yet their exact role in asthma management remains unclear, despite omalizumab now being incorporated into several international asthma guidelines. As with many aspects of pediatric care, this is driven by a lack of appropriately designed pediatric trials. Extrapolation of data reported in adult studies may be appropriate for adolescent asthma, but is not for younger age groups, in which important pathophysiological differences exist. Novel drugs under development offer potential for benefit in the future, but to date existing data are in most cases limited to adults. Pediatric asthma also offers unique potential to prevent or modify the underlying pathophysiology. Although attempts to do so have been unsuccessful to date, advances may yet come from this approach, as our understanding about the interaction between genetics, environmental factors, and viral illness improve. This review provides an overview of the newer treatment options available for management of pediatric asthma and discusses the merits of other novel therapies in development, as we search to optimize management and improve future outcomes.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. Dr Robinson has no conflicts of interest directly relevant to the content of this review. Dr Van Asperen has participated in advisory boards of MSD, GlaxoSmithKline and Novartis, and has received speaker’s honoraria from MSD.

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  1. Department of Respiratory Medicine, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia

    Paul D. Robinson & Peter Van Asperen

  2. Faculty of Medicine, Discipline of Paediatrics and Child Health, The Children’s Hospital at Westmead Clinical School, Sydney Medical School, University of Sydney, Westmead, NSW, Australia

    Paul D. Robinson & Peter Van Asperen

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Robinson, P.D., Van Asperen, P. Newer Treatments in the Management of Pediatric Asthma. Pediatr Drugs 15, 291–302 (2013). https://doi.org/10.1007/s40272-013-0020-x

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