Biologics for Asthma and Allergic Skin Diseases in Children

Pediatrics. 2021 Nov 1;148(5):e2021054270. doi: 10.1542/peds.2021-054270. Epub 2021 Oct 18.


An estimated 7 million children in the United States have asthma, which causes a significant health care burden and affects quality of life. The minority of these children have asthma that does not respond to Global Initiative for Asthma steps 4 and 5 care, and biological medications are recommended at this level in the 2019 Global Initiative for Asthma recommendations. In addition, biologics have been introduced into the care of children with allergic skin diseases. Omalizumab and mepolizumab are approved for children as young as 6 years, and benralizumab and dupilumab are approved for people aged ≥12 years. Reslizumab is approved only for people aged ≥18 years. These monoclonal antibodies may be added for appropriate patients when asthma or allergic skin diseases are not well controlled. Pediatricians and pediatric subspecialists should work together and be aware of the benefits and risks of these medications for their patients, as well as the practical implications of providing these options for their patients. This clinical report serves as an evaluation of the current literature on these types of medications in the treatment of children with asthma and allergic skin disease.

MeSH terms

  • Adolescent
  • Anti-Allergic Agents / therapeutic use
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Asthma / therapy*
  • Biological Products / therapeutic use*
  • Child
  • Dermatitis, Atopic / therapy
  • Humans
  • Hypersensitivity / therapy*
  • Omalizumab / therapeutic use
  • Skin Diseases / therapy*
  • Urticaria / therapy


  • Anti-Allergic Agents
  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Omalizumab
  • reslizumab
  • dupilumab
  • benralizumab
  • mepolizumab