Biological therapy of severe bronchial asthma in children: Indications and effectiveness criteria

Abstract

Bronchial asthma is one of the most common chronic diseases in children. Severe asthma is defined by the European Respiratory Society and American Thoracic Society as asthma that requires treatment with high-dose combination therapy of inhaled corticosteroids in combination with long-acting bronchodilators and/or with the use of systemic corticosteroids, or remains uncontrolled despite treatment. In the structure of severity, severe asthma occupies about 5%, but it leads to a maximum decrease in quality of life, causes disability, and also requires significant expenditure of health care resources. Therefore, selection of therapy for severe bronchial asthma remains an important task. The introduction of monoclonal antibody drugs into practice makes it possible to improve the control of severe bronchial asthma in children at the 5th stage of therapy. The first biological drug to treat severe asthma was Omalizumab, and over twenty years of its use has been shown to be effective in controlling symptoms, reducing the frequency of exacerbations, and improving lung function. Our study assessed the effectiveness of biological therapy. Treatment with omalizumab led to in a reduction in the frequency of symptoms, number of exacerbations, total IgE, and improvement of lung function as assessed by spirography. No severe reactions to the drug were observed. The article presents a clinical example of long-term use of omalizumab in a patient with severe bronchial asthma, which made it possible to achieve control over the disease, improve quality of life and reduce the volume of basic therapy, while no adverse reactions to the drug were recorded.