Breathing normally becomes a business. It seems that the bronchi shrink and do not let the air pass, with the consequent "starvation" of oxygen and the appearance of breathlessness and other ailments.
Keeping asthma under control, even when it appears in children, is essential, and not only for the impact on health. For children who suffer from it, in fact, not recognizing the inflammatory pathology and not treating it in the best possible way means “stealing” something in terms of quality of life: it becomes more difficult to play with others, have fun, play sports. The important thing, in the most serious forms, is that the therapy is tailor-made. Experts remember this, explaining how important it is to "phenotype", that is to choose treatments based on the invisible characteristics that lead to the disease. And above all, a warning comes from science: always rely on the specialist who, together with the pediatrician, can choose the most suitable therapies case by case.
When is asthma really severe?
Fortunately, cases of severe asthma in children are not common. The data confirm this. "Bronchial asthma is constantly increasing in the pediatric population: in about five cases out of a hundred of the total pediatric asthmatic population, the disease assumes the characteristics of severe asthma, which must be recognized and followed up at a specialized center" explains Gian Luigi Marseglia , President Siaip (Italian Society of Pediatric Allergy and Immunology). "In a child over 6 years of age, asthma is defined as severe if it requires continued high dose inhaled steroid treatment for at least one year, or treatment with systemic steroids, and despite this the symptoms are not controlled, or worsen as the therapy itself decreases. Care must therefore be taken in the diagnosis, avoiding confusing the so-called "difficult" to treat asthma: it is estimated that 39-55% of children with uncontrolled asthma classified as "severe" have "difficult to treat" asthma. In any case, the important thing is to monitor the situation. In case of "out of control" asthma despite treatment, it is necessary that the child is evaluated and followed by a specialist for an adequate period, that any elements that may affect the management of the disease such as adherence to treatment are eliminated and that to a diagnosis of real "severe" asthma. At this point, thanks to research, it is now possible to offer, when the indication exists, also therapy with biological drugs, some of which have also been authorized for pediatric patients. The important thing is that the choice is made by the specialist. "In the child, as in the adult, the key word is appropriateness: it is necessary to recognize severe asthma, develop a treatment path and insert the biological drug in the therapeutic strategy when it is indicated" recalls Giorgio Piacentini, full professor of Pediatrics at the University of Verona.
Why "phenotype" the patient
In short: the important thing is to focus on precision medicine, even when asthma is severe and it is necessary to make the best use of the "power" of monoclonal antibodies that act on a specific target identified as the cause of the patient's asthma. For the use of these biological drugs, the present and the future will therefore be based on the identification of specific biomarkers, i.e. proteins or other molecules measurable in blood or other biological liquids, which will allow us to understand in advance which drug will be suitable for every single patient. Meanwhile, even for the little ones, the treatment options for these forms are growing, thanks to the availability of medicines registered by the regulatory authorities of the famaci which, like intelligent bullets, go to act exactly where they are needed.
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Tag: Asthma Children