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Abstract

Background: Severe asthma remains a major challenge, particularly for patients unresponsive to standard inhaled corticosteroids and long-acting bronchodilators. Biologic therapies targeting inflammatory pathways, such as IL-5, IL-4, and IgE, have shown promise in improving treatment outcomes. However, differences in response between pediatric and adult patients require further investigation. Objective: This meta-analysis evaluates the efficacy and safety of biologic therapies in pediatric and adult patients with severe asthma, comparing outcomes such as asthma exacerbations and lung function improvement (FEV₁). Methods: A systematic search across PubMed, Embase, Cochrane Library, and Web of Science identified randomized controlled trials (RCTs), cohort studies, and observational studies assessing biologic therapies in severe asthma. Statistical analyses, including pooled effect sizes and heterogeneity assessments, were performed using Review Manager (RevMan) and Stata software. Results: The meta-analysis included 10 studies with 12,932 patients (9,527 adults; 3,405 pediatric). Biologic therapies significantly reduced asthma exacerbations in both groups, though adults showed a stronger response (OR: 0.60 – 0.68, p<0.05) compared to pediatric patients (OR: 0.75 – 0.78, p<0.05). FEV₁ improvements were notable in pediatric patients (mean increase: 150 mL, p<0.05). Safety profiles were comparable between both groups, with no significant increase in severe adverse events. Conclusion: Biologic therapies effectively reduce exacerbation rates and improve FEV₁ in both pediatric and adult patients with severe asthma. However, treatment response appears stronger in adults, potentially due to differences in immune system maturity and medication adherence. Further research is needed to assess long-term efficacy and safety, particularly in pediatric populations.