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Overview of severe asthma, with emphasis on pediatric patients: a review for practitioners
  1. Arabelle Abellard1,
  2. Andrea A Pappalardo1,2
  1. 1 Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
  2. 2 Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Andrea A Pappalardo, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; apappa2{at}


Asthma is the most common life-threatening chronic disease in children. Although guidelines exist for the diagnosis and treatment of asthma, treatment of severe, pediatric asthma remains difficult. Limited studies in the pediatric population on new asthma therapies, complex issues with adolescence and adherence, health disparities, and unequal access to guideline-based care complicate the care of children with severe, persistent asthma. The purpose of this review is to provide an overview of asthma, including asthma subtypes, comorbidities, and risk factors, to discuss diagnostic considerations and pitfalls and existing treatments, and then present existing and emerging therapeutic approaches to asthma management. An improved understanding of asthma heterogeneity, clinical characteristics, inflammatory patterns, and pathobiology can help further guide the management of severe asthma in children. More studies are needed in the pediatric population to understand emerging therapeutics application in children. Effective multimodal strategies tailored to individual characteristics and a commitment to address risk factors, modifiers, and health disparities may help reduce the burden of asthma in the USA.

  • asthma
  • respiration disorders
  • airway obstruction
  • lung diseases

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  • Contributors Both authors have contributed to the manuscript and agreed with the final version of the manuscript. AA and AP are credited with substantial contribution to the design of the work, literature review of all the sections discussed, revision of critically important intellectual content, final approval of the published version, and agreement of accountability for all aspects of the work. AA and AP are credited with significant design of the tables and graphs, literature review of all sections, revision of important intellectual content for the discussion, and agreement of accountability for all parts of the work. AA and AP are credited with literature review, final content write-up, and agreement of accountability for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AP serves a consultant for OptumRx/UnitedHealth Group. She also is on the Board of Directors of the Chicago Asthma Consortium.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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