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Ullmann N, Bush A, Piacentini G, Santamaria F, Cutrera R. Editorial: Difficult and severe asthma in children, volume II. Front Pediatr 2023; 11:1158309. [PMID: 37009299 PMCID: PMC10061068 DOI: 10.3389/fped.2023.1158309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/27/2023] [Indexed: 04/04/2023] Open
Affiliation(s)
- Nicola Ullmann
- Pneumology and Cystic Fibrosis Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy
- Correspondence: Nicola Ullmann
| | - Andrew Bush
- Professor of Paediatrics, National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Professor of Paediatrics and Paediatric Respirology, National Heart and Lung Institute, London, United Kingdom
- Consultant Paediatric Chest Physician, Royal Brompton Harefield NHS Foundation Trust, London, United Kingdom
| | - Giorgio Piacentini
- Professor of Paediatrics and Head of Paediatric Section AOUI Verona, University of Verona, Verona, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Pediatric Pulmonology, Federico II University, Naples, Italy
| | - Renato Cutrera
- Pneumology and Cystic Fibrosis Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy
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Ullmann N, Peri F, Florio O, Porcaro F, Profeti E, Onofri A, Cutrera R. Severe Pediatric Asthma Therapy: Mepolizumab. Front Pediatr 2022; 10:920066. [PMID: 35844748 PMCID: PMC9283570 DOI: 10.3389/fped.2022.920066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second controller. In this scenario, mepolizumab, a humanized monoclonal antibody, has proven to be effective in controlling eosinophil proliferation by targeting interleukin-5 (IL-5), a key mediator of eosinophil activation pathways. Mepolizumab is approved since 2015 for adults at a monthly dose of 100 mg subcutaneously and it has been approved for patients ≥ 6 years of age in 2019. Especially in children aged 6 to 11 years, mepolizumab showed a greater bioavailability, with comparable pharmacodynamics parameters as in the adult population. The recommended dose of 40 mg every 4 weeks for children aged 6 through 11 years, and 100 mg for patients ≥ 12 years provides appropriate concentration and proved similar therapeutic effects as in the adult study group. A marked reduction in eosinophil counts clinically reflects a significant improvement in asthma control as demonstrated by validated questionnaires, reduction of exacerbation rates, and the number of hospitalizations. Finally, mepolizumab provides a safety and tolerability profile similar to that observed in adults with adverse events mostly of mild or moderate severity. The most common adverse events were headache and injection-site reaction. In conclusion, mepolizumab can be considered a safe and targeted step-up therapy for severe asthma with an eosinophilic phenotype in children and adolescents.
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Affiliation(s)
- Nicola Ullmann
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Peri
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Olivia Florio
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Respiratory Medicine Unit, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Federica Porcaro
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elisa Profeti
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Onofri
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Renato Cutrera
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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