New Therapeutic Approaches in the Management and Outcomes of Pediatric Asthma

Background: Asthma continues to lead to significant health issues and deaths worldwide, and there has been little progress in treatment outcomes over the past ten years, even though treatment costs have risen.

Methodology: This mini review compared new therapeutic approaches for treatment of pediatric asthma, searching the literature from May 2004 to August 2024 using PubMed, MEDLINE, ScienceDirect and CINAHL. Keywords such as ‘Mepolizumab,’ ‘Omalizumab,’ ‘pediatric asthma,’ and ‘biologic therapies’ were used, along with MeSH terms. After screening and full text review, 26 of 642 initial studies were selected for inclusion. This literature review explores emerging therapeutic approaches for managing pediatric asthma, focusing on monoclonal antibody treatments, inhaled corticosteroids, long-acting muscarinic antagonists (LAMAs), macrolides, vitamin D supplementation, and innovative devices like temperature-controlled laminar airflow (TLA) and electronic monitoring tools.

Results: In patients with severe eosinophilic asthma, monoclonal antibody therapies such as omalizumab and mepolizumab reduced exacerbations by 48% with omalizumab and 53% with mepolizumab. Long acting muscarinic antagonists and macrolides also led to improvements in lung function and a reduction in flare ups. Supplementation with vitamin D and temperature controlled laminar airflow devices were found to improve asthma control, especially in children with vitamin D deficiency and severe asthma.

Conclusion: Recent advancements in pediatric asthma treatment, including monoclonal antibodies, inhaled corticosteroids, non-pharmacological devices, long-acting muscarinic antagonists (LAMAs), macrolides, vitamin D supplementation have shown significant improvements in asthma control and quality of life. These therapies offer personalized approaches, particularly for children with severe asthma or specific inflammatory phenotypes. Future research should explore the long-term safety of biologics and investigate cost-effective methods to introduce these therapies in underserved regions.