ReviewLancet (London, England)2010
Management of severe asthma in children.
Review in Lancet (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 216 citations in OpenAlex.
- Features of asthma which provide meaningful insights for understanding the disease heterogeneity.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2018Trial
- Randomised trial of once-daily vilanterol in children with asthma on inhaled corticosteroid therapy.Respiratory research · 2016Trial
- Pharmacokinetics of terbutaline in chronic kidney disease.European journal of clinical pharmacology · 2013Trial
- Anti-asthmatic effects and ingredient annotation of the active fraction from Ganoderma lucidum.Journal of natural medicines · 2026Article
- ST2Clinical and translational allergy · 2025Article
- Severe Asthma and Biological Therapies: Now and the Future.Journal of clinical medicine · 2023Review
- Interactions between neutrophils and T-helper 17 cells.Frontiers in immunology · 2023Review
- Severe asthma in children: An official statement from Saudi Pediatric Pulmonology Association.Saudi medical journal · 2022Article
- Identification of key genes and pathways between mild-moderate and severe asthmatics via bioinformatics analysis.Scientific reports · 2022Article
- Reduced pediatric urgent asthma utilization and exacerbations during the COVID-19 pandemic.Pediatric pulmonology · 2021Article
- Severe asthma in South Africa: A literature review and management approach for primary care.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2021Review
- Evaluation of Glucocorticoid Therapy in Asthma Children with Small Airway Obstruction Based on CT Features of Deep Learning.Computational and mathematical methods in medicine · 2021Article
- 2021 Brazilian Thoracic Association recommendations for the management of severe asthma.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2021Review
- Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction.Journal of asthma and allergy · 2021Review
- Asthma control and psychological health in pediatric severe asthma.Pediatric pulmonology · 2021Article
- Difficult and Severe Asthma in Children.Children (Basel, Switzerland) · 2020Review
- Kids, Difficult Asthma and Fungus.Journal of fungi (Basel, Switzerland) · 2020Review
- Which Child with Asthma is a Candidate for Biological Therapies?Journal of clinical medicine · 2020Review
- Pulmonary type-2 innate lymphoid cells in paediatric severe asthma: phenotype and response to steroids.The European respiratory journal · 2019Article
- Review
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Children who are referred to specialist care with asthma that does not respond to treatment (problematic severe asthma) are a heterogeneous group, with substantial morbidity. The evidence base for management is sparse, and is mostly based on data from studies in children with mild and moderate asthma and on extrapolation of data from studies in adults with severe asthma. In many children with severe asthma, the diagnosis is wrong or adherence to treatment is poor. The first step is a detailed diagnostic assessment to exclude an alternative diagnosis ("not asthma at all"), followed by a multidisciplinary approach to exclude comorbidities ("asthma plus") and to assess whether the child has difficult asthma (improves when the basic management needs, such as adherence and inhaler technique, are corrected) or true, therapy-resistant asthma (still symptomatic even when the basic management needs are resolved). In particular, environmental causes of secondary steroid resistance should be identified. An individualised treatment plan should be devised depending on the clinical and pathophysiological characterisation. Licensed therapeutic approaches include high-dose inhaled steroids, the Symbicort maintenance and reliever (SMART) regimen (with budesonide and formoterol fumarate), and anti-IgE therapy. Unlicensed treatments include methotrexate, azathioprine, ciclosporin, and subcutaneous terbutaline infusions. Paediatric data are needed on cytokine-specific monoclonal antibody therapies and bronchial thermoplasty. However, despite the interest in innovative approaches, getting the basics right in children with apparently severe asthma will remain the foundation of management for the foreseeable future.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.