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Respiratory Disorders, Allergic Conditions CE/CME accredited

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Improving outcomes in severe paediatric asthma: New treatments, new possibilities

  • Downloads including slides are available for this activity in the Toolkit
Learning Objectives

After watching this activity, participants should be better able to:

  • Recall the symptoms associated with severe asthma in children
  • Summarize the clinical evidence supporting the use of biologics in children with severe asthma
  • Describe the optimal long-term management of children with severe asthma

In this activity, an asthma specialist and a primary care respiratory specialist respond to questions from healthcare professionals involved in the care of paediatric patients with severe asthma. They discuss the symptoms and diagnosis of childhood asthma, the latest data and rationale for the use of biologics in children, and the long-term management of these patients.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

This activity has been designed to meet the educational needs of allergists, immunologists, paediatricians, pulmonologists and general practice physicians involved in the management of paediatric patients with severe paediatric asthma.


USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.


Dr Leonard Bacharier discloses: Advisory board/Panel fees from AstraZeneca (relationship terminated), GlaxoSmithKline (relationship terminated), Regeneron Pharmaceuticals, Sanofi and Vertex Pharmaceuticals. Consultancy fees from OMPharma. Speaker’s bureau Fees from Regeneron Pharmaceuticals.

Dr Dermot Ryan discloses: Consultant fees from Regeneron Pharmaceuticals (relationship terminated) and Thermo Fisher Scientific. Speaker’s bureau fees from Glenmark Pharmaceuticals and Viatris (relationship terminated).

Content reviewer

Karim Hanna, MD has no relevant financial relationships to disclose.

Touch Medical Director

Adriano Boasso has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact 



This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 15 December 2022. Dates credits expire: 15 December 2023.

If you have any questions regarding credit please contact


This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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  • Downloads including slides are available for this activity in the Toolkit

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Improving outcomes in severe paediatric asthma: New treatments, new possibilities
0.75 CE/CME credit

Question 1/5
A 9-year-old boy, who was diagnosed with asthma based on spirometry and FEV1, has been receiving medium-dose ICS-LABA treatment for 9 months. He has returned to your clinic as his symptoms remain uncontrolled. What should your next step be before making a diagnosis of severe asthma?

FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroids; IgE, immunoglobulin E; LABA, long-acting beta2-agonist; OCS, oral corticosteroids.

Environmental or behavioural risk factors can worsen asthma symptoms and interfere with disease control.1,2 Managing these risk factors can help reduce the risk of exacerbations.1 Patients should be assessed for management of potentially modifiable risk factors, such as ensuring proper inhaler technique and treatment adherence, and ensuring comorbidities, such as allergic rhinitis, are correctly managed.1


  1. Global Initiative for Asthma. Available at: (accessed 14 November 2022).
  2. Martin J, et al. BMJ Paediatr Open. 2022;6:e001277.
Question 2/5
When should biologics be initiated in children with a confirmed asthma diagnosis?

ICS, inhaled corticosteroids; LABA, long-acting beta2-agonist; OCS, oral corticosteroids.

According to the GINA Global Strategy, patients with asthma that remains uncontrolled despite adherence to medium- or high-dose ICS-LABA and management of other contributing factors, should be referred for phenotypic assessment before initiating treatment with biologic therapy.


GINA, Global Initiative for Asthma; ICS, inhaled corticosteroids; LABA, long-acting beta2-agonist.


Global Initiative for Asthma. Available at: (accessed 14 November 2022).

Question 3/5
How can you support parents or carers to better manage the symptoms of your paediatric patients with severe asthma?

Patients should be checked for potentially modifiable risk factors as part of their asthma assessment.1 Factors such as environmental exposure to allergens, exposure to smoke, viral respiratory tract infections or comorbidities can trigger symptom onset and should be monitored and managed where possible.1,2


  1. Global Initiative for Asthma. Available at: (accessed 14 November 2022).
  2. Martin J, et al. BMJ Paediatr Open. 2022;6:e001277.
Question 4/5
Which of the following is predictive of response to biologic therapy?

CT, computed tomography; FeNO, fractional exhaled nitric oxide; IgE, immunoglobulin E.

Patient assessment can guide biologic selection. Eosinophilic inflammation is driven by type-2 cytokines, and elevated blood eosinophil count is a predictive biomarker of biologic therapy efficacy. Increased FeNO is also predictive of improved response to various biologic agents, although not for anti-IL-5 agents.1 Combined elevated eosinophils and increased FeNO may also further increase the predictive power of these biomarkers.2


FeNO, fractional exhaled nitric oxide; IL-5, interleukin 5.


  1. Runnstrom M, et al. J Inflamm Res. 2022;15:241–9.
  2. Kroes J, et al. Biochem Pharmacol. 2020;179:113978.
Question 5/5
Which of the following statements about asthma presentation in children is true?

Respiratory symptoms are common in children and are often non-specific or appear as respiratory infections.1 These non-specific symptoms should not be used for diagnosis.1 Symptoms in children are usually virally triggered and patients may present few symptoms prior to experiencing an upper airway infection.2 Instead, diagnosis should be based on documented airflow limitation.1,3


  1. Gaillard E, et al. Eur Respir J. 2021;58:2004173.
  2. Trivedi M, Denton E. Front Pediatr. 2019;7:256.
  3. Global Initiative for Asthma. Available at: (accessed 14 November 2022).
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