Age-specific efficacy of biologics in severe asthma: a pediatric perspective

Severe pediatric asthma is a rare yet burdensome disease, often unresponsive to conventional anti-asthmatic treatments and associated with significant morbidity, impaired lung development, and high healthcare use. Over the last two decades, biologic therapies have deeply changed the treatment of severe asthma, with both clinical and functional efficacy and a favorable safety profile. However, most studies and clinical trials on the field have focused on adults, leaving a relevant gap in pediatric-specific evidence. Since pediatric responses may deeply diverge from adults due to age-specific immunological and physiological factors, this narrative review aims to summarize current pediatric-specific evidence on the efficacy and safety of Europe-licensed anti-asthmatic biologics for pediatric severe asthma, highlighting key differences from adult data and discussing emerging challenges and future research directions such preventive use of biologics, innovative delivery methods, combination treatments, standardized definitions of asthma remission and development of pediatric-specific outcome measures, ultimately leading to individualized therapy.