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Biologics for paediatric severe asthma: trick or TREAT?

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journal contribution
posted on 17.04.2019, 14:43 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 Sinha
While 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 Inflammation

Version

AM (Accepted Manuscript)

Published in

Lancet Respiratory Medicine

Publisher

Elsevier

eissn

2213-2619

Acceptance date

24/01/2019

Copyright date

2019

Available date

01/10/2019

Publisher version

https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S2213260019300451?returnurl=https://linkinghub.elsevier.com/retrieve/pii/S2213260019300451?showall=true&referrer=

Notes

The file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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