Authors
Virshich K.I.1, Bzasezhev Z.R.2, Podolyan A.R.2, Khokhlach M.A.2, Tsulaia A.D.2
1 N.N. Burdenko Voronezh state medical university, Voronezh
2 Kuban state medical university, Krasnodar
Abstract
Rationale: Pediatric bronchial asthma (BA) remains a major concern in clinical practice due to its high prevalence and substantial impact on quality of life. Long-term disease prognosis may vary depending on the selected treatment strategy.
Objective: To analyze the efficacy of current pharmacological treatments for pediatric BA and to assess long-term clinical outcomes.
Methods: A structured review of publications from PubMed, Scopus, Web of Science, Cochrane Library, and eLibrary databases was conducted for the period 2019–2025. The analysis included randomized controlled trials, cohort studies, and meta-analyses addressing the effectiveness of asthma therapy in patients under 18 years of age.
Results: Inhaled glucocorticosteroids are the foundation of maintenance therapy and demonstrate high efficacy when administered at the lowest effective dose. With long-term use of high doses, suppression of the hypothalamic–pituitary–adrenal axis may occur; however, no significant effects on children’s growth or mineral metabolism have been identified. Excessive use of short-acting β₂-agonists is associated with an increased risk of exacerbations. Biological therapy has shown effectiveness in children with severe allergic asthma phenotypes and marked eosinophilia.
Conclusion: Current pharmacological strategies, including inhaled glucocorticosteroids, β₂-agonists, leukotriene receptor antagonists, and monoclonal antibodies – not only provide symptom control but also influence long-term outcomes. Close safety monitoring and adherence to principles of personalized treatment are essential.
Keywords: bronchial asthma, children, inhaled glucocorticosteroids, beta-2 agonists, montelukast, omalizumab, stepwise therapy, long-term outcomes.
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