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Severe Asthma in School-Age Children: Evaluation and Phenotypic Advances

  • Allergens (RK Bush and JA Woodfolk, Section Editors)
  • Published:
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Abstract

Although the majority of children with asthma have a favorable clinical response to treatment with low to moderate doses of inhaled corticosteroids (ICS), a small subset of children have “severe” asthma characterized by ongoing symptoms and airway inflammation despite treatment with high doses of ICS and even oral corticosteroids. Although there is symptom heterogeneity in the affected children, children with severe asthma share the risk for adverse outcomes, including recurrent and potentially life-threatening exacerbations, which contribute to substantial economic burden. This article reviews current knowledge of severe asthma in school-age children (age 6–17 years) with a focus on recent literature published after January 2012. Clinical management approaches for children with severe asthma are discussed as well as current phenotyping efforts and emerging phenotypic-directed therapies that may be of benefit for subpopulations of children with severe asthma in the future.

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Abbreviations

ATS:

American Thoracic Society

COPD:

Chronic obstructive pulmonary disease

ERS:

European Respiratory Society

FEV1 :

Forced expiratory volume in one second

FVC:

Forced vital capacity

ICS:

Inhaled corticosteroid

IgE:

Immunoglobulin E

Th2:

T helper type 2

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Conflict of Interest

Leonard B. Bacharier reports consultancies from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, Schering, Cephalon, DBV Technologies, and Teva. Anne M. Fitzpatrick reports consultancies from MedImmune, Merck, GlaxoSmithKline, Genentech, and Boehringer Ingelheim. Andrea Coverstone declares no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Pediatrics, Washington University, St. Louis, MO, USA

    Andrea Coverstone & Leonard B. Bacharier

  2. Department of Pediatrics, Emory University, 2015 Uppergate Drive, Atlanta, GA, 30322, USA

    Anne M. Fitzpatrick

  3. Center for Cystic Fibrosis and Airways Disease Research, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Anne M. Fitzpatrick

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  1. Andrea Coverstone
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  2. Leonard B. Bacharier
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Correspondence to Anne M. Fitzpatrick.

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Coverstone, A., Bacharier, L.B. & Fitzpatrick, A.M. Severe Asthma in School-Age Children: Evaluation and Phenotypic Advances. Curr Allergy Asthma Rep 15, 20 (2015). https://doi.org/10.1007/s11882-015-0521-5

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