Vom Hove Maike, Neininger Martina P, Bertsche Thilo, Prenzel Freerk
Hospital for Children and Adolescents, Leipzig University Medical Center, Leipzig, Germany.
Drug Safety Center, Institute of Pharmacy, Leipzig University, Leipzig, Germany.
Handb Exp Pharmacol. 2020;261:131-151. doi: 10.1007/164_2019_307.
The management of atopic diseases such as severe asthma, severe atopic dermatitis, and severe food allergy in childhood is challenging. In particular, there are safety concerns regarding the use of high-dose corticosteroids. The recent development of biologicals and their approval for the treatment of children offer a new, very promising, and more personalized therapy option. Omalizumab, mepolizumab, and dupilumab are currently approved as add-on treatments of severe asthma in children and have been shown to be effective in improvement of asthma control and reduction of exacerbations. Dupilumab is the only biological approved for the treatment of atopic dermatitis in adolescents so far. It has been demonstrated to significantly improve symptoms of atopic dermatitis.However, safety data for biologicals used in atopic diseases in children and adolescents are still very limited. Biologicals are generally considered to be safe in adults. These data are often extrapolated to children. Additionally, data for long-term use are lacking. Thus, the safety profiles of those biologicals cannot yet be conclusively assessed.
儿童期重度哮喘、重度特应性皮炎和重度食物过敏等特应性疾病的管理具有挑战性。特别是，高剂量皮质类固醇的使用存在安全问题。生物制剂的最新发展及其在儿童治疗中的获批提供了一种新的、非常有前景且更具个性化的治疗选择。奥马珠单抗、美泊利单抗和度普利尤单抗目前被批准作为儿童重度哮喘的附加治疗药物，并且已被证明在改善哮喘控制和减少发作方面有效。度普利尤单抗是迄今为止唯一被批准用于治疗青少年特应性皮炎的生物制剂。它已被证明能显著改善特应性皮炎的症状。然而，儿童和青少年特应性疾病中使用生物制剂的安全性数据仍然非常有限。生物制剂在成年人中一般被认为是安全的。这些数据常常被外推到儿童身上。此外，缺乏长期使用的数据。因此，这些生物制剂的安全性概况尚未能得到最终评估。
