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Author Notes:

Corresponding author: Theresa Guilbert, M.D., The Department of Pediatrics, Division of Pulmonology Medicine, Cincinnati Children's Hospital & Medical Center, 3333 Burnet Avenue, MLC 2021, Cincinnati, OH 45229, Office: (513) 803-0493, Theresa.Guilbert@cchmc.org

Subject:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Allergy
  • Immunology
  • Childhood severe asthma
  • Childhood difficult-to-treat asthma
  • Severe asthma phenotypes
  • Childhood severe asthma treatment
  • Review
  • QUALITY-OF-LIFE
  • RELATIVE CORTICOSTEROID INSENSITIVITY
  • GASTROESOPHAGEAL-REFLUX DISEASE
  • INHALED FLUTICASONE PROPIONATE
  • GENOME-WIDE ASSOCIATION
  • IMPROVED LUNG-FUNCTION
  • EXHALED NITRIC-OXIDE
  • AIR-FLOW OBSTRUCTION
  • STEP-UP THERAPY
  • BRONCHIAL THERMOPLASTY

Severe Asthma in Children

Tools:

Journal Title:

Journal of Allergy and Clinical Immunology: In Practice

Volume:

Volume 2, Number 5

Publisher:

, Pages 489-500

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

Copyright information:

© 2014 American Academy of Allergy, Asthma & Immunology.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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