Nicole Chase, MD, FAAP, FACAAI, FAAAAI

The panel offers their final recommendations for physicians managing patients with asthma.

The panel discusses the biologic drugs approved for use in children with asthma, including omalizumab, dupilumab, mepolizumab, and the recently approved benralizumab. They share their preferences among these options for improving lung function in pediatric patients.

Robert Sporter, MD, discusses the initial conversations he has with pediatric patients and their parents when considering biologic therapies, addressing the risks associated with not treating the condition, such as compromised lung function and increased steroid use. He emphasizes the importance of communicating a comprehensive treatment plan, including contingencies for cases where a particular therapy may not be effective.

Shahzad Mustafa, MD, examines the pediatric atopic march, a phenomenon characterized by the sequential development of wheezing, asthma, and food allergies in children, discussing the progression and interrelationship of these conditions. He also explores the potential benefits of early intervention with medications in managing these conditions in pediatric patients.

Robert Sporter, MD, explores the differences in treatment approaches between adult and pediatric populations, focusing on allergy-based asthma treatments such as allergen immunotherapy and biologics, and their specific applications in managing asthma in children.

Medical experts discuss eligibility criteria for biologic therapies, noting that biologics can be used for other allergies and in patients with comorbidities, highlighting the potential for these targeted treatments to benefit a broad age range of patients.

Sande Okelo, MD, leads a discussion on the updates in the GINA 2021 report regarding difficult-to-treat and severe asthma, as well as considerations for GINA Step 4 and 5 treatment approaches.

The expert panel discusses the use of biologics in treating asthma, explaining their mechanisms of action, differences, and target populations, while also examining trends in long-term efficacy and safety for patients with severe or uncontrolled asthma.

The key opinion leaders explore the utilization of biomarkers in guiding the treatment of severe or uncontrolled asthma, discussing the specific role of eosinophils in informing therapeutic decision-making for patients with challenging asthma cases.

Sande Okelo, MD, outlines the factors that contribute to the overuse of oral corticosteroids (OCS), such as nonadherence, poor inhaler technique, inappropriate prescription, and comorbidities, while also discussing strategies to limit OCS overuse and acknowledging that undertreatment can also be a significant issue.

The panel addresses the issue of patients being exposed to high levels of oral corticosteroids (OCS) without realizing it, as various prescribers can administer steroids. They also discuss the essential questions healthcare professionals should ask to comprehend a patient's total OCS exposure and provide a definition of high OCS use.

The key opinion leaders deliberate on the criteria used to classify a patient as having moderate or severe asthma, as well as the factors that determine when a patient's asthma is deemed uncontrolled—including the use of combination therapy and daily symptoms.

The panelists explore the significance of type 2 inflammation in asthma, including its role and associated markers, while also delving into their approach to assessing patients whose asthma is triggered or worsened by allergies, examining markers beyond IgE and noting the frequency of patients presenting with asthma symptoms during allergy season without actually having allergic asthma.

S Shahzad Mustafa, MD, discusses various asthma endotypes and phenotypes, considering factors such as race, age of onset, gender, BMI, and lung function test results.

Nicole Chase, MD; S Shahzad Mustafa, MD; Sande Okelo, MD, and Robert Sporter, MD, examine the distinct manifestations of asthma stemming from allergic and non-allergic origins, as well as the factors contributing to its exacerbation.

Raffi Tachdjian, MD, MPH, FAAAAI, FACAAI; Dareen D. Siri, MD, FAAAAI, FACAAI; Nicole Chase, MD, FAAP, FACAAI, FAAAAI; and Andrew White, MD, give final thoughts on asthma management, considering the current treatment landscape.

Experts outline biomarkers to measure asthma, highlighting eosinophil count and fractional exhaled nitric oxide levels.

Experts discuss the use of biologic treatment in asthma by primary care physicians vs pulmonology specialists as well as overcoming barriers to biologic use through patient and physician education.

Experts comment on switching from 1 biologic treatment to another, as well as combining biologics with steroids or other treatments in asthma.

Andrew White, MD, discusses choosing the right biologic for patients with severe asthma, considering factors such as asthma comorbidities as well as patient preference.

Dareen D. Siri, MD, FAAAAI, FACAAI, reviews the efficacy and safety of dupilumab for the treatment of asthma, as well as which patients are good candidates for dupilumab.

Nicole Chase, MD, FAAP, FACAAI, FAAAAI, provides an overview of the difference between single and dual inhibition of interleukins, focusing on dupilumab as a dual inhibitor for asthma treatment.

Experts discuss the use of biologic agents to manage asthma and describe the mechanisms of action of different biologics.

Medical expert highlights the risk of overuse of oral corticosteroids in the management of asthma and reviews alternative treatment options.

Andrew White, MD, reviews the definition of difficult-to-treat or severe asthma as outlined in the GINA (Global Initiative for Asthma) guidelines.

Experts discuss the process of choosing a treatment plan for patients with severe allergic or eosinophilic asthma.

Andrew White, MD, provides an overview of the asthma treatment landscape, focusing on inhaled and oral corticosteroids, as well as biologic and nonbiologic agents.

Dareen D. Siri, MD, FAAAAI, FACAAI, reviews the tools available to predict the exacerbation of asthma, highlighting spirometry and biomarkers as effective tools

A panel of experts comment on primary care vs specialist care for patients with asthma, and when patients should be referred to a specialist.

Dareen D. Siri, MD, FAAAAI, FACAAI, reviews the symptoms of coughing, wheezing, and shortness of breath as a product of an overactive immune system and as a sign of asthma.