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

  • Andrea Coverstone
  • Leonard B. Bacharier
  • Anne M. Fitzpatrick
Allergens (RK Bush and JA Woodfolk, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Allergens

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.

Keywords

Severe asthma Children Asthma diagnosis Asthma treatment Asthma evaluation Asthma phenotype 

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

Notes

Compliance with Ethics Guidelines

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.

Human and Animal Rights and Informed Consent

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

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Andrea Coverstone
    • 1
  • Leonard B. Bacharier
    • 1
  • Anne M. Fitzpatrick
    • 2
    • 3
  1. 1.Department of PediatricsWashington UniversitySt. LouisUSA
  2. 2.Department of PediatricsEmory UniversityAtlantaUSA
  3. 3.Center for Cystic Fibrosis and Airways Disease ResearchChildren’s Healthcare of AtlantaAtlantaUSA

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