Severe Asthma in Children: Lessons Learned and Future Directions

J Allergy Clin Immunol Pract. 2016 Jan-Feb;4(1):11-9; quiz 20-1. doi: 10.1016/j.jaip.2015.10.008.


Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.

Keywords: Children; Endotype; Inflammation; Lung function; Phenotype; Severe asthma.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use*
  • Animals
  • Asthma / drug therapy*
  • Child
  • Disease Progression
  • Drug Dosage Calculations
  • Humans
  • National Heart, Lung, and Blood Institute (U.S.)
  • Population*
  • Severity of Illness Index
  • United States


  • Adrenal Cortex Hormones