Position Paper on management of mild asthma in childhood. A statement proposed by the SIMRI Asthma Committee and approved by the SIMRI Advocacy Council and Executive Committee

Mild asthma in children and adolescents has traditionally been considered a less impactful condition characterized by infrequent symptoms. However, emerging evidence recognizes it as a chronic inflammatory disease with potential for severe, life-threatening exacerbations. Recent evidence and guidelines highlight the need for a paradigm shift in the management of mild asthma, moving away from exclusive reliance on short-acting beta2-agonists (SABA), towards proactive, inflammation-targeted asthma management across pediatric age groups. Non-pharmacological interventions—such as avoiding exposure to tobacco smoke, promoting healthy lifestyles, addressing psychosocial factors, and controlling environmental triggers—are equally critical to improving outcomes. A holistic, personalized approach that incorporates both medical and lifestyle interventions is pivotal for effective control of mild asthma, reduction of exacerbation risks, and improvement of long-term outcomes and quality of life in pediatric patients. This statement summarizes current evidence and presents the official recommendations of the Italian Pediatric Respiratory Society (IPRS, Società Italiana per le Malattie Respiratorie Infantili/Ente Terzo Settore– SIMRI/ETS) to guide best practices in the management of mild asthma in childhood.