Background: The significance of periostin as a biomarker of TH2-induced airway inflammation, and as a measure of the response to TH2-targeted therapy, has recently been emphasized. The aim of this prospective study was to analyze the serum periostin levels in the follow-up and management of asthma in children treated with inhaled corticosteroids (ICS), Methods: Thirty-six asthmatic children aged from 6 to 18 years, previously treated or not with ICS were included. Following an international consensus (GINA), the patients were submitted to standard treatment with inhaled corticosteroid for 12 months according to the severity of the disease. Baseline and post-intervention measures were serum periostin levels, fractional exhaled nitric oxide (FeNO), spirometry and Asthma Control Test (ACT). Results: Significant improvements from baseline were observed in ACT at follow – up ( P=0.02). Serum periostin levels were increased in 33 of the 36 subjects with asthma at 1 year follow – up. The serum periostin levels changes were not significantly correlated with changes in ACT nor in pulmonary functions. A significant reduction in FeNO levels with concomitant changes in ACT was observed ((0.427% decrease for each doubling of biomarker levels from baseline, P = 0.035). Conclusion: Monitoring of the serum periostin levels indicated significant increases during the ICS treatment, demonstrating that serial measurement of periostin levels may not reflect the adequate management of asthma in children.