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A targeted strategy is part of personalized medicine which aims to better define each patient's phenotype and endotype so as to prescribe the most suitable treatment at an individual level. Omalizumab and, more recently, mepolizumab are the first biologics approved for children (6\u201018\u00a0years). Omalizumab is now widely used to treat severe allergic asthma in children and is highly effective for asthma exacerbations and asthma control with a good safety profile. Moreover, several other drugs\u2014lebrikizumab<jats:italic>,<\/jats:italic> dupilumab, tezepelumab, mepolizumab, reslizumab, benralizumab\u2014are used or are being studied in both teenagers and adults and could benefit younger children in the near future. We hypothesize that defining the asthma phenotype\/endotype regarding the type and intensity of inflammation, association with allergic or non\u2010allergic comorbidities, and airway remodeling should contribute to the choice of a specific biologic. Pediatric specificities have to be addressed and validated by studies in children. Long\u2010term effectiveness and particularly the impact on the natural history of asthma should also be investigated. Severe asthma in children is a complex disease, and patients have to be referred to a specialized pediatric asthma center to confirm diagnosis and initiate the best treatment strategy which could include biologics while taking into account their high cost.<\/jats:p>","DOI":"10.1111\/pai.13007","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T19:37:58Z","timestamp":1542397078000},"page":"159-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["New perspectives of childhood asthma treatment with biologics"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5646-2429","authenticated-orcid":false,"given":"Jocelyne","family":"Just","sequence":"first","affiliation":[{"name":"Department of Allergology\u2014Centre de l'Asthme et des Allergies H\u00f4pital d'Enfants Armand Trousseau, Assistance Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"UMR\u2010S 1136, Equipe EPAR INSERM Sorbonne Universit\u00e9, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2006-7221","authenticated-orcid":false,"given":"Antoine","family":"Deschildre","sequence":"additional","affiliation":[{"name":"CHU Lille, Pediatric Pulmonology and Allergy Department H\u00f4pital Jeanne de Flandre, Universit\u00e9 Nord de France  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7009-2113","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Lejeune","sequence":"additional","affiliation":[{"name":"CHU Lille, Pediatric Pulmonology and Allergy Department H\u00f4pital Jeanne de Flandre, Universit\u00e9 Nord de France  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7843-7999","authenticated-orcid":false,"given":"Flore","family":"Amat","sequence":"additional","affiliation":[{"name":"Department of Allergology\u2014Centre de l'Asthme et des Allergies H\u00f4pital d'Enfants Armand Trousseau, Assistance Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"UMR\u2010S 1136, Equipe EPAR INSERM Sorbonne Universit\u00e9, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01672.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2014.05.015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01655-2017"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3300"},{"issue":"1","key":"e_1_2_6_6_1","first-page":"1352020","article-title":"International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma","volume":"52","author":"Chung KF","year":"2018","journal-title":"Eur Respir J"},{"key":"e_1_2_6_7_1","unstructured":"Global Initiative for Asthma.Global Strategy for Asthma Management and Prevention 2018.www.ginasthma.org. 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