Cited by 72Asthma and respiratory diseasesAllergic Rhinitis and SensitizationIndoor Air Quality and Microbial Exposure

Individualized household allergen intervention lowers allergen level but not asthma medication use: a randomized controlled trial

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DiMango, Emily, Serebrisky, Denise, Narula, Surinder, Shim, Chang, Keating, Claire, Sheares, Beverly, Perzanowski, Matthew, Miller, Rachel +6 more·2016·The Journal of Allergy and Clinical Immunology: In Practice

Abstract

Background Environmental exposures to indoor allergens are major contributors to asthma symptoms, particularly in inner cities. The effectiveness of household allergen reduction as an adjunct to National Asthma Education Prevention Program guideline-based pharmacologic therapy in asthma has not been prospectively studied.Objective To study the effect of individualized allergen reduction on ability to reduce asthma pharmacologic therapy over 40 weeks.Methods We performed a randomized controlled trial to determine the effect of multifaceted indoor allergen avoidance measures on the ability to reduce asthma controller therapy in adults and children residing in New York City who were both sensitized and exposed to at least 1 indoor allergen. Asthma treatment and control were optimized in all subjects before randomization.Results A total of 125 subjects were randomized to receive individualized household allergen reduction and 122 received a sham intervention. Subjects in the intervention group significantly reduced all measured allergen levels (cat, dog, dust mite allergens in the bedroom, cockroach and mouse allergens in the kitchen and bedroom); those in the control group reduced only dust mite and mouse allergens in the bedroom and cockroach allergen in the kitchen. Participants in the intervention arm reduced National Asthma Education Prevention Program-based therapy from step 4.4 at randomization to 3.50 postintervention (range, 0-6); participants in the control arm reduced medication from step 4.4 to 3.4 (P = .76). There were no differences in other measured asthma outcomes.Conclusions Targeted allergen avoidance measures do not allow for reduction in asthma pharmacologic therapy compared with usual care in patients already receiving optimal controller therapy.

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Crossref · 10.1016/j.jaip.2016.01.016

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  • In that 2016 trial, despite modest reductions in multiple indoor allergens in the intervention group, there were no statistically significant differences in allergen levels between intervention and control groups for most exposures by the end of the study.

    “Although the intervention group achieved modest reductions in multiple indoor allergens, there were no statistically significant differences in allergen levels between the intervention and control groups for most exposures by the end of the study.”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [53]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • One possible explanation for the lack of benefit on treatment step is that allergen levels were lowered in both groups and did not differ significantly between them.

    “One possible explanation for the lack of benefit on treatment step is that allergen levels were lowered in both groups and were not significantly different between groups (53).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [53]

    The Results report that allergen levels fell in both groups, though all measured allergens declined significantly only in the intervention group; asthma treatment step did not differ significantly between groups. The Discussion says allergen reductions in the control group made the intervention’s effect on treatment harder to assess. Neither passage establishes the claim’s specific assertion that allergen levels were not significantly different between groups. (LLM, conf=0.83)

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  • Although allergen reduction may improve the indoor environment, its inconsistent effect on controller medication treatment step, especially in well-managed patients, and the lack of sustained reductions in several studies limit definitive conclusions about long-term benefits.

    “Although allergen reduction may contribute to a healthier indoor environment, its inconsistent impact on controller medication treatment step, particularly in well-managed patients, combined with the lack of sustained reductions in several studies, limits definitive conclusions about long-term benefits (53).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [53]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured
  • Modest reductions in allergen levels may not produce clinical benefits.

    “Additionally, modest lowering of allergen levels may not translate to clinical benefits (53).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [53]

    The Abstract Results and Discussion report reduced household allergen levels without an additional reduction in asthma medication use or improvement in other measured asthma outcomes. The paper does not characterize the allergen reductions as modest, so it supports the clinical point but not that description of their magnitude. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • In that 2016 trial, no significant differences were found in other asthma-related health outcomes.

    “Additionally, no significant differences were observed in other asthma-related health outcomes (53).”

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Authors
DiMango, E., Serebrisky, D., Narula, S., Shim, C., Keating, C., Sheares, B., Perzanowski, M., Miller, R., DiMango, A., Andrews, H., Merle, D., Liu, X., Calatroni, A., & Kattan, M.
Affiliations
  • Columbia University Irving Medical Center (US)
  • Jacobi Medical Center (US)
  • Columbia University (US)
  • Rho (United States) (US)
Corresponding author
DiMango, Emily
Venue
The Journal of Allergy and Clinical Immunology: In Practice
Publisher
Elsevier BV
Published
2016-07
Volume
4
Issue
4
Pages
671-679.e4
ISSN
2213-2198 (ISSN-L)
OpenAlex
W2310152440
Cited by
72
References
45
Citations by year
2026: 1 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 8 · 2021: 6 · 2020: 5 · 2019: 12 · 2018: 8 · 2017: 14 · 2016: 2
FWCI
9.65
Type
journal article
Language
en
Open access
Locations
  • The Journal of Allergy and Clinical Immunology In Practice (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Environmental Health Sciences (P30ES009089)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
indoor allergens, allergen avoidance, asthma control, house dust mite allergens, cockroach allergens, mouse allergen, controller therapy, inner-city asthma, New York City
MeSH terms
Adolescent, Adult, Aged, Allergens, Animals, Asthma, Cats, Child, Cockroaches, Dogs, Environmental Exposure, Female, Forced Expiratory Volume, Housing, Humans, Male, Middle Aged, New York City, Urban Population, Anti-Asthmatic Agents, Pyroglyphidae, Mice, Young Adult

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