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Meta-Analysis
. 2003;2001(1):CD002989.
doi: 10.1002/14651858.CD002989.

Pet allergen control measures for allergic asthma in children and adults

S Kilburn  1 , T J Lasserson, M McKean
Affiliations
Meta-Analysis

Pet allergen control measures for allergic asthma in children and adults

S Kilburn et al. Cochrane Database Syst Rev. 2003.

Abstract

Background: Although pet removal has been recommended in guidelines on the management of allergic asthma, pet ownership remains high in families where one or more members have an allergy to pet dander. Allergen control measures such as air filtration units placed in the homes of pet-allergic asthmatics have been used as a means of reducing allergen exposure.

Objectives: To determine the clinical efficacy of pet allergen control measures in the homes of people with pet-allergic asthma.

Search strategy: An electronic search of the Cochrane Controlled Trials Register was carried out. No restriction was placed on language of publication.

Selection criteria: Randomised controlled trials comparing an active allergen reduction measure with control were considered for analysis. Participants had stable pet-allergic asthma.

Data collection and analysis: 34 references were identified by electronic searching, but only three appeared suitable for potential inclusion in the review. Two met the inclusion criteria for the analysis. Both examined the effectiveness of air filtration units. Two reviewers extracted data independently. A limited amount of data were usable for a meta-analysis.

Main results: Both trials were small (n=22 and n=35). No significant differences were detected between active intervention and control on the primary and secondary outcome measures reported in the studies. Data on absence from school or work were not reported in either study. No meta-analysis could be performed due to lack of common outcomes.

Reviewer's conclusions: The available trials are too small to provide evidence for or against the use of airfiltration units to reduce allergen levels in the management of pet-allergic asthma. Adequately powered trials are needed. There are no trials of other allergen reduction measures, such as pet washing or possibly pet removal.

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Conflict of interest statement

None known.

Figures

1
1
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
1.1
1.1. Analysis
Comparison 1 HEPA air filter versus sham filter, Outcome 1 Bronchial hyperresponsiveness (PC20).
1.2
1.2. Analysis
Comparison 1 HEPA air filter versus sham filter, Outcome 2 Morning peak flow.
1.3
1.3. Analysis
Comparison 1 HEPA air filter versus sham filter, Outcome 3 Evening peak flow.
1.4
1.4. Analysis
Comparison 1 HEPA air filter versus sham filter, Outcome 4 Peak flow variability.
1.5
1.5. Analysis
Comparison 1 HEPA air filter versus sham filter, Outcome 5 Sleeping difficulty at 3 months.
See this image and copyright information in PMC

References

References to studies included in this review

van der Heide 1999 {published data only}
    1. Heide S, Aaldsen WMC, KauffmanHF, Dubois AEJ, Monchy JGR. Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergen. Journal of Allergy and Clinical Immunology 1999;104(2):447‐51. - PubMed
Wood 1998 {published data only}
    1. Wood RA, Johnson EF, Natta ML, Hua Chen P, Eggleston PA. A placebo‐controlled trial of a HEPA air cleaner in the treatment of cat allergy. American Journal of Respiratory and Critical Care Medicine 1998;158:115‐20. - PubMed

References to studies excluded from this review

Antonicelli 1991 {published data only}
    1. Antonicelli L, Bilo MB, Pucci S, Schou C, Bonifazi F. Efficacy of an air‐cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy. Allergy 1991;46:594‐600. - PubMed
Bjornsdottir 2003 {published data only}
    1. Bjornsdottir US, Jakobinudottir S, Runarsdottir V, Juliusson S. The effect of reducing levels of cat allergen (Fel d 1) on clinical symptoms in patients with cat allergy. Annals of Allergy, Asthma, & Immunology 2003;91(2):189‐94. - PubMed
Boquete 1997 {published data only}
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Carter 2001 {published data only}
    1. Carter MC, Perzanowski MS, Raymond A, Platts‐Mills TA. Home intervention in the treatment of asthma among inner‐city children. Journal of Allergy & Clinical Immunology 2001;108(5):732‐7. - PubMed
De Blay 2003 {published data only}
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Francis 2003 {published data only}
    1. Francis H, Fletcher G, Anthony C, Pickering C, Oldham L, Hadley E, et al. Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens. Clinical & Experimental Allergy 2003;33:101‐5. - PubMed
Gore 2003 {published data only}
    1. Gore RB, Bishop S, Durrell B, Curbishley L, Woodcock A, Custovic A. Air filtration units in homes with cats: can they reduce personal exposure to cat allergen?. Clinical & Experimental Allergy 2003;33(6):765‐9. - PubMed
Karlsson 2004 {published data only}
    1. Karlsson AS, Andersson B, Renstrom A, Svedmyr J, Larsson K, Borres MP. Airborne cat allergen reduction in classrooms that use special school clothing or ban pet ownership. Journal of Allergy & Clinical Immunology 2004;113(6):1172‐7. - PubMed
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Reisman 1990 {published data only}
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Sabbah 2000 {published data only}
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van der Heide 1997 {published data only}
    1. Heide S, Kauffman HF, Dubois AE, Monchy JG. Allergen reduction measures in houses of allergic asthmatic patients: effects of air‐cleaners and allergen‐impermeable mattress covers. European Respiratory Journal 1997;10:1217‐23. - PubMed
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References to ongoing studies

Rolfsjord 2005 {unpublished data only}
    1. Air cleaners for children and adolescents with asthma and dog allergy. Ongoing study Starting date of trial not provided. Contact author for more information.

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