What is the role of allergen avoidance in the long-term management of asthma?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Allergen avoidance takes different forms, depending on the specific allergen size and characteristic. Improvement in symptoms after avoidance of the allergen should result rather rapidly, though the allergen itself (eg, cat dander) may linger in the environment for months after primary removal of the source. A multifaceted approach is necessary, as individual interventions are rarely successful by themselves.

Comprehensive allergen avoidance during the first year of life effectively prevents the onset of asthma in individuals with a high genetic risk, with the effect occurring early in childhood and persisting through adulthood, according to one study. In the trial, 120 children at high risk for allergic disorders were randomized into prophylactic (n=58) and control (n=62) groups. The infants in the intervention group were either breast fed (with the mother on a low allergen diet) or given an extensively hydrolyzed formula. The control group followed standard advice. At age 18, a significantly lower prevalence of asthma was observed in the intervention arm compared to the control group (10.7% and 25.9%, respectively). An overall reduction in asthma prevalence from 1 to 18 years was also observed in assessments performed at ages 1, 2, 4, 8 and 18 years. [74]


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