Abstract

Focus on drug development for asthma has been on development of immunomodulator therapies, with the hopes that they can eventually alter the natural course of asthma. This review focuses on the currently available immunomodulating therapies for children. Allergen immunotherapy has been long used as an approach in allergic asthma in children and has the potential ability to alter the natural course of asthma over time. Omalizumab, a humanized anti-IgE specific form of IgG, is the best studied of a new crop of antiallergic mediator immunotherapy. Other, newer modalities, such as anti-IL-5 (mepolizumab, reslizumab, and benralizumab) and combined anti-IL 4/13 (dupilumab), have additionally shown promise; however, these have not been extensively studied in children. We will review mechanism of action, pharmacology, and current literature regarding efficacy of these new therapies for childhood asthma. It is our hope that, with future studies, one or more of these agents may be helpful in altering the onset and progression of severe asthma in children.

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