Heather De Keyser, MD, MS: The Promise of Biologics in Pediatric Asthma and Atopic Dermatitis

The emotional and psychological implications of asthma and atopic dermatitis on pediatric populations have been thoroughly evaluated in both the pulmonary and dermatological fields.

The burdens these conditions present have prompted clinicians to constantly be seeking new and promising methods in treating affected children and adolescents, the most prominent of which have been the use of biologics.

In an interview with HCPLive, Heather De Keyser, MD, MS, Assistant Professor, Pediatric Pulmonology Breathing Institute, University of Colorado School of Medicine and Children's Hospital Colorado, spoke of the promise that biologics such as mepolizumab and dupilumab present in the treatment of vulnerable pediatric groups with asthma and atopic dermatitis.

De Keyser spoke of an algorithm she and fellow investigators proposed in her presentation “Biologics for Asthma and Allergic Skin Diseases”.

The presentation was accepted for the American Academy of Pediatrics (AAP) 2021 Virtual National Conference & Exhibition.

The algorithm De Keyer and colleagues proposed would involve the standard diagnostic steps for treating pediatric patients. Once the appropriate diagnosis is made, patients and caregivers would be asked about any medications the child is currently using to treat their condition.

“(Once)you've done all of those things, you make sure they have the right diagnosis that they're taking their medications and they don't have any other risk factors that you can modify, then you want to say ‘do they have severe or difficult to treat asthma?’”, De Keyser said. “So, is it not controlled despite being on high doses of inhaled steroid medications, or do they need daily oral steroid medications? If they fall into that category, that that's really a kid that we might want to start thinking about.”

Some biologics such as omalizumab and dupilumab have already been indicated for the treatment of atopic dermatitis and asthma in certain pediatric populations.

Despite the high efficacy rate, De Keyser Mepolizumab stressed the need for proper, thorough discussions between patients, parents/caregivers, and clinicians on the implications of these approved biologics.

“It's really a community effort,” De Keyser said. “(and) it involves a good relationship between the healthcare provider, whether that be the pediatrician, the pediatric subspecialists, and the family to make sure that the child is having the appropriate response to medications, make sure that they actually are doing better on these medicines, (and) making sure that they're not having too many side effects from the medicines”

De Keyser believed that in addition to continued research into the use of these medications, the future of pediatric care would be defined by successful, long-term use of biologics in young patients, and potential remodeling early on in the management of asthma and atopic dermatitis.

“So that's something that's really in the future, that's what we're really researching now, to make sure that we can kind of move in that direction,” De Keyser said. “What we know so far is that generally these medications are effective in reducing asthma exacerbations and they appear to be safe and well tolerated in the pediatric population, and so I think that's really where the medicines at right now, but there's really exciting research going on for the future as well.”

To hear more insights from Dr. De Keyser on the benefits of biologic care, watch the video interview above.