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• W2917767426 abstract "Although most asthma in UK children can be controlled with low to moderate doses of inhaled corticosteroids, there remains a small group with severe disease and poor control despite maximal treatment whose needs are unmet. There are stark differences in the health care received by this group compared with that of adults with similar clinical characteristics. Unlike adults, children with severe asthma are not treated at specialist centres, clinical trials of novel therapeutics are not tailored for children, and novel biologics are being approved without evidence of efficacy. In adults, severe asthma is managed in a commissioned service, and only named specialist centres can assess patients and prescribe biologics. A systematic assessment at a dedicated severe asthma centre is associated with improved quality of life and asthma control and a reduction in health-care use. 1 Gibeon D Heaney LG Brightling CE et al. Dedicated severe asthma services improve health-care use and quality of life. Chest. 2015; 148: 870-876 Summary Full Text Full Text PDF PubMed Scopus (91) Google Scholar This multidisciplinary assessment helps to identify remediable factors, such as poor adherence, and ensures that appropriate patients are started on costly biologics. By contrast, despite international guideline recommendations, 2 Chung KF Wenzel SE Brozek JL et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014; 43: 343-373 Crossref PubMed Scopus (2425) Google Scholar there is no such service provision or specification for children in the UK and most other parts of the world, even though children with severe asthma have associated long-term morbidities, including development of chronic obstructive pulmonary disease in adulthood. 3 Tai A Tran H Roberts M Clarke N Wilson J Robertson CF The association between childhood asthma and adult chronic obstructive pulmonary disease. Thorax. 2014; 69: 805-810 Crossref PubMed Scopus (214) Google Scholar Without specialist services, children could be exposed to potential harm associated with inappropriate prescribing of biologics, or they could be denied an appropriate therapy, and an absence of accurate monitoring will result in a missed opportunity to assess the benefit of biologics across the lifespan as disease modifying drugs. 4 Szefler SJ Asthma across the lifespan: time for a paradigm shift. J Allergy Clin Immunol. 2018; 142: 773-780 Summary Full Text Full Text PDF PubMed Scopus (28) Google Scholar" @default.
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• W2917767426 date "2019-04-01" @default.
• W2917767426 modified "2023-10-04" @default.
• W2917767426 title "Biologics for paediatric severe asthma: trick or TREAT?" @default.
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• W2917767426 doi "https://doi.org/10.1016/s2213-2600(19)30045-1" @default.
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