Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group

Indolfi, Cristiana; Klain, Angela; Capuano, Maria Cristina; Colosimo, Simone; Rapillo, Renata; Miraglia del Giudice, Michele

doi:10.3390/children12020167

Open AccessEditor’s ChoiceReview

Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group

by

Cristiana Indolfi

^†,

Angela Klain

^†

,

Maria Cristina Capuano

^*,

Simone Colosimo

,

Renata Rapillo

and

Michele Miraglia del Giudice

Department of Woman, Child and General and Specialized Surgery, University of Campania ‘Luigi Vanvitelli’, 80138 Naples, Italy

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Children 2025, 12(2), 167; https://doi.org/10.3390/children12020167

Submission received: 30 December 2024 / Revised: 24 January 2025 / Accepted: 27 January 2025 / Published: 29 January 2025

(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)

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Abstract

This review examines the growing role of biological therapies in managing severe asthma in children aged 6–11 years. Severe asthma, characterized by persistent symptoms and frequent exacerbations, presents significant challenges in pediatric care. Biologic treatments, including mepolizumab, omalizumab, and dupilumab, provide targeted interventions for patients with high eosinophilic inflammation or allergic asthma (T2-high asthma). Alongside their therapeutic benefits, the review evaluates the safety profiles of these biologics, highlighting potential side effects and the necessity for monitoring during long-term use. Cost considerations and treatment adherence also emerge as important challenges that need to be addressed in clinical practice. Additionally, the review emphasizes the need for identifying patients who would derive the most benefit from biologic therapies, advocating for the development of biomarkers to aid in treatment decisions. Emerging biologics, such as tezepelumab, are introduced as promising alternatives with the potential to target upstream inflammatory pathways, offering hope for treating T2-low asthma forms, which currently lack effective treatment options in children.

Keywords: severe asthma; children; school-age; treatment; biologicals; biomarkers

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MDPI and ACS Style

Indolfi, C.; Klain, A.; Capuano, M.C.; Colosimo, S.; Rapillo, R.; Miraglia del Giudice, M. Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group. Children 2025, 12, 167. https://doi.org/10.3390/children12020167

AMA Style

Indolfi C, Klain A, Capuano MC, Colosimo S, Rapillo R, Miraglia del Giudice M. Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group. Children. 2025; 12(2):167. https://doi.org/10.3390/children12020167

Chicago/Turabian Style

Indolfi, Cristiana, Angela Klain, Maria Cristina Capuano, Simone Colosimo, Renata Rapillo, and Michele Miraglia del Giudice. 2025. "Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group" Children 12, no. 2: 167. https://doi.org/10.3390/children12020167

APA Style

Indolfi, C., Klain, A., Capuano, M. C., Colosimo, S., Rapillo, R., & Miraglia del Giudice, M. (2025). Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group. Children, 12(2), 167. https://doi.org/10.3390/children12020167

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Severe Asthma in School-Age Children: An Updated Appraisal on Biological Options and Challenges in This Age Group

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