Biological Therapies in Children and Adolescents with Severe Uncontrolled Asthma: A Practical Review

Martina Votto,1,2,* Maria De Filippo,1,2,* Amelia Licari,1,2 Alessia Marseglia,2 Mara De Amici,3 Gian Luigi Marseglia1,2 1Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; 3Immuno-Allergology Laboratory, Clinical Chemistry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy*These authors contributed equally to this workCorrespondence: Amelia LicariPediatric Clinic, Fondazione IRCCS Policlinico San Matteo, p.le C. Golgi n.19, Pavia, 27100, ItalyTel/Fax +390382502629Email amelia.licari@unipv.itAbstract: Severe uncontrolled asthma is a complex and heterogeneous disease. A multidisciplinary assessment is required to correctly identify and manage children and adolescents with severe asthma because they may require strict monitoring and additional treatment with advanced targeted therapies. Recent research efforts have focused on identifying epidemiologic, clinical, and molecular mechanisms that underlie severe asthma, leading to the recognition of different phenotypes and endotypes and identifying biomarkers able to predict the response to biologic therapies. Additional progress has occurred by introducing biological therapies that have revolutionized the care of chronic allergic diseases in the adult and pediatric population. In this review, we briefly summarized the current literature on biological therapies to treat severe asthma in children and adolescents.Keywords: severe asthma, children, adolescents, biological therapy, endotype, phenotype