Childhood obesity is a growing global health concern with significant cardiometabolic consequences. While conventional treatment approaches often fail to achieve sustained outcomes, emerging digital health interventions (DHIs)—including mobile applications, educational video games, wearable devices, telemedicine, and social media—offer innovative tools to support lifestyle modifications and enhance therapeutic adherence. In this narrative review, we focus on the main evidence regarding the effectiveness of DHIs for pediatric obesity treatment according to target (children vs. children with families) and duration (short- and long-term interventions). We also review their impact on clinical (e.g. body mass index, body composition, etc.), behavioral (physical activity, nutrition, adherence) and psychosocial (motivation, engagement) outcomes. In addition, future trends in the field are also discussed. DHIs demonstrate short-term effectiveness, especially when they incorporate personalization, interactivity, and family involvement. Mobile applications and educational video games boost nutritional literacy and promote healthy behaviours. Wearable devices encourage physical activity awareness, though adherence often varies. Long-term, family-based interventions help reduce dropout rates and reinforce lasting healthy habits. Guided use of social media can facilitate health education but also exposes users to risks such as misinformation and unhealthy food marketing. Despite these advancements, DHIs still face major challenges, including unequal access, data privacy concerns, and a lack of long-term outcome evaluations. The increasing prevalence of pediatric obesity underscores the urgent need for effective and sustainable treatment strategies. DHIs represent a promising, scalable approach for managing childhood obesity, but their long-term sustainability and effectiveness remain to be fully established. Ongoing technological advancements—and their thoughtful integration into existing healthcare frameworks—present significant opportunities to develop innovative, patient-centered therapeutic solutions that can improve engagement, adherence, and long-term health outcomes in children and adolescents with obesity.

Pediatric obesity represents a growing global health challenge, closely associated with increased cardiometabolic risk and long-term adverse outcomes. Although lifestyle modifications remain the cornerstone of treatment, sustained success is often limited. Emerging evidence suggests that the gut microbiota (GM) plays a pivotal role in the pathogenesis of obesity, influencing host metabolism, energy homeostasis, and systemic inflammation. This narrative review aims to provide a comprehensive and up-to-date overview of the complex interplay between GM and pediatric obesity, with a particular emphasis on microbiota-targeted interventions. These include probiotics, prebiotics, synbiotics, postbiotics, dietary modulation, and fecal microbiota transplantation (FMT). Findings from preclinical studies and early-phase clinical trials indicate that gut dysbiosis may contribute to obesity-related mechanisms, such as altered nutrient absorption, increased adiposity, and dysregulated appetite control. Interventions targeting the microbiota have shown promise in modulating inflammatory pathways and improving metabolic profiles. While preliminary findings underscore the potential of the GM as a novel adjunctive target in managing pediatric obesity, current evidence remains heterogeneous, and robust clinical pediatric data are limited. Further research is needed to clarify the therapeutic efficacy, safety, and long-term outcomes of microbiota-modulating strategies in children with obesity.

Allergic rhinitis (AR) is a common chronic respiratory disease that significantly impairs the life of children. While a combination intranasal spray of azelastine hydrochloride and fluticasone propionate (Aze-Flu) is an established effective treatment for adults with moderate-to-severe AR, the clinical evidence available in the pediatric population is limited. This review summarizes the current evidence on the efficacy, safety, and impact on Quality of Life (QoL) of Aze-Flu in children. Clinical trials have demonstrated that Aze-Flu provides faster and greater symptom relief in children with AR compared to fluticasone propionate (FP) monotherapy. One randomized controlled trial demonstrated that, although the overall change in the reflective Total Nasal Symptom Score (rTNSS) was not statistically different from the placebo, this was possibly due to rater assessment bias. Children’s symptoms self-assessment showed considerable ameliorations in both nasal and ocular scores. Furthermore, treatment with Aze-Flu has been shown to produce clinically relevant and statistically significant improvements in QoL compared to placebo in children with moderate-to-severe seasonal AR. The safety profile is favorable; a 3-month study confirmed that Aze-Flu is well-tolerated, with an incidence of treatment-related adverse events comparable to that of FP monotherapy. Beyond AR, emerging evidence suggests potential benefits of Aze-Flu in children with adenoid hypertrophy. The available evidence supports Aze-Flu as an effective and well-tolerated therapeutic option for children with moderate-to-severe AR, offering superior and faster symptom control than monotherapy and leading to meaningful improvements in quality of life. Future pediatric trials should incorporate validated, child-specific assessment tools to better capture treatment efficacy.