paediatric severe asthma-LRM comment-101218-final.pdf (175.16 kB)
Biologics for paediatric severe asthma: trick or TREAT?
journal contribution
posted on 2019-04-17, 14:43 authored by S Saglani, A Bush, W Carroll, S Cunningham, L Fleming, E Gaillard, A Gupta, C Murray, P Nagakumar, J Paton, G Roberts, P Seddon, I SinhaWhile most asthma in UK children can be controlled with low-moderate dose inhaled corticosteroids
(ICS), there remains a small group with severe disease and poor control despite maximal treatment
whose needs are unmet because of discrimination compared to adults. Severe asthma is a
commissioned service for adults with only named specialist centres able to 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 utilisation(1). This
multidisciplinary assessment helps to identify remediable factors such as poor adherence and ensures
that appropriate patients are started on costly biologics. In contrast, although international guidelines
exist(2), there is no such service provision or specification for children, despite clear evidence of their
long-term morbidity, including development of chronic obstructive pulmonary disease in
adulthood(3), and the potential risks associated with the prescription of biologics.
Funding
WC reports grants from Trudell Medical International; personal fees from Novartis, Trudell Medical International, Circassia, Orion, and GSK; and nonfinancial support from Novartis and Trudell Medical International. LF reports grants from Asthma UK; and support to her institution from Boehringer Ingelheim, AstraZeneca, GSK, Sanofi, Respiri, and Novartis. EG reports grants from Chiesi, Gilead Sciences, and Circassia; non-financial support and collaboration from MedImmune; a travel grant from Vertex; and support to his institution from Boehringer Ingelheim and Anaxsys. AG reports support to his institution from GSK and Novartis; personal fees from GSK and Novartis; and non-financial support from Novartis. CM reports grants from the National Institute for Health Research; personal fees from Novartis, GSK, and AstraZeneca; and educational grants from Novartis, GSK, and AstraZeneca.
History
Citation
Lancet Respiratory Medicine, 2019, 7(4), pp. 294-296.Author affiliation
/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and InflammationVersion
- AM (Accepted Manuscript)