Effect of pet removal on pet allergic asthma.
BACKGROUND
Allergen avoidance has been recommended in the management of allergic asthma. Very few studies have assessed the effect of pet removal on pet allergic asthma.


OBJECTIVE
We examined the effect of pet removal from homes on pulmonary function testing, airway hyperresponsiveness, and medication use.


METHODS
Prospective, nonrandomized, nonblinded observational study.


METHODS
Subjects included 20 symptomatic patients with newly diagnosed pet allergic asthma who were keeping domestic animals, including hamsters, cats, dogs, and ferrets, and were sensitized to the animals. They were treated with inhaled corticosteroids or other medications according to recommendations by level of severity of the Global Initiative for Asthma. Methacholine inhalation tests were performed regularly before and after starting medication. Clinical features were compared between the patients who gave away their pets according to recommendations by the clinician (removal group) and the patients who refused to give away their pets (keeping group).


RESULTS
There were 10 patients in both the removal group and the keeping group. After >or= 1 year of follow-up with or without pet removal, a 5.9-fold increase in the provocative concentration of methacholine causing a 20% fall in FEV(1) was observed in the removal group compared with a 2.3-fold increase in the keeping group (p = 0.04). There were no significant differences in the changes in FEV(1) and peak flow variability. Finally, no patient received inhaled corticosteroids in the removal group, whereas all but one of the patients needed beclomethasone dipropionate (mean dose, 600 mug/d) in the keeping group.


CONCLUSIONS
This study indicates that removal of pets from homes reduces airway responsiveness in patients with pet allergic asthma more than optimal pharmacotherapy alone, thereby enabling a decrease in inhaled corticosteroid doses.
Shirai
Toshihiro
T
Department of Internal Medicine, Fujinomiya City General Hospital, 3-1 Nishiki-cho, Fujinomiya, 418-0076, Japan. fmyhsp@lilac.ocn.ne.jp
Matsui
Takashi
T
Suzuki
Kenichiro
K
Chida
Kingo
K
D000328:Adult; D000818:Animals; D000829:Animals, Domestic / Q000276:immunology; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control*; D001985:Bronchial Provocation Tests; D002867:Chromones / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D039981:Pyroglyphidae / Q000276:immunology; D012129:Respiratory Function Tests; D013806:Theophylline / Q000008:administration & dosage
D018927:Anti-Asthmatic Agents; D002867:Chromones; D013806:Theophylline; C047681:pranlukast