BACKGROUND: Despite remarkable advances in our understanding of asthma, there are still several unmet needs associated with the management of pediatric asthma. METHODS: A two-day, face-to-face meeting was held in London, United Kingdom, on October 28 and 29, 2017, involving a group of international expert clinicians and scientists in asthma management to discuss the challenges and unmet needs that remain to be addressed in pediatric asthma. RESULTS: These unmet needs include a lack of clinical efficacy and safety evidence, and limited availability of non-steroid-based alternative therapies in patients <6 years of age. An increased focus on children is needed in the context of clinical practice guidelines for asthma; current pediatric practice relies mostly on extrapolations from adult recommendations. Furthermore, no uniform definition of pediatric asthma exists, which hampers timely and robust diagnosis of the condition in affected patients. CONCLUSIONS: There is a need for a uniform definition of pediatric asthma, clearly distinguishable from adult asthma. Furthermore, guidelines which provide specific treatment recommendations for the management of pediatric asthma are also needed. Clinical trials and real-world evidence studies assessing anti-immunoglobulin E (IgE) therapies and other monoclonal antibodies in children <6 years of age with asthma may provide further information regarding the most appropriate treatment options in these vulnerable patients. Early intervention with anti-IgE and non-steroid-based alternative therapies may delay disease progression, leading to improved clinical outcomes.

Astrid Lindgren Children's Hospital Lung and Allergy Unit Karolinska University Hospital Stockholm Sweden

CHU Lille Pediatric Pulmonology and Allergy Unit Hôpital Jeanne de Flandre CHRU de Lille and Université Nord de France Lille France

Department of Paediatrics Imperial College London London UK

Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany

Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden

Departments of Pediatrics and Epidemiology and Biostatistics Philip R Lee Institute for Health Policy Studies University of California San Francisco California

Division of Infection Inflammation and Respiratory Medicine The University of Manchester Manchester UK

Division of Respiratory Medicine Department of Pediatrics Child Health Evaluative Sciences Hospital for Sick Children University of Toronto Toronto Ontario Canada

Novartis Pharma AG Basel Switzerland

Observational and Pragmatic Research Institute Singapore Singapore

Pediatric Allergy and Immunology Boston Children's Hospital Boston Massachusetts

Pediatric Allergy and Immunology Unit Children's Hospital Ain Shams University Cairo Egypt

Pediatric Department 2nd Faculty of Medicine Charles University Prague and University Hospital Motol Prague Czech Republic

Pediatric Pulmonology and Allergy Unit Children's Hospital La Fe Valencia Spain

School of Medicine Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre Brazil

School of Paediatrics and Faculty of Child Health and Medical Sciences University of Western Australia Perth Western Australia Australia

The Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece

University of Aberdeen Aberdeen UK

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