Childhood asthma is a heterogeneous inflammatory condition. Immunological pathways driving the chronic inflammation differ per individual patient.

The introduction of biologics as add-on therapy for severe asthma has revolutionized severe asthma management and paved the way for precision medicine in children and adolescents.

Five biologics are currently licensed to treat severe asthma in children and/or adolescents: omalizumab (anti-IgE), mepolizumab (anti-IL5), benralizumab (anti-IL5Rα), dupilumab (anti-IL4Rα), and tezepelumab (anti-TSLP).

Despite marketing approval access to these biologics differ per country, and indicators to guide choice of the biologic and monitor treatment success are scarce.

Especially for the most recently approved biologics, such as dupilumab and tezepelumab, efficacy and safety data in the pediatric population is scarce.