"Managing a asthma is challenging enough on its own, but add indoor pet allergen into the mix and it is downright dangerous and costly" Russell Settipane, MD Associate Editor, Allergy & Asthma Proceedings
Providence, RI (PRWEB) October 11, 2010
Asthma costs related to pet ownership in the US has been estimated to be as much as $1 Billion according to a study published this month in Allergy & Asthma Proceedings, the scientific journal representing both the American Association of Certified Allergists, as well as the Regional, State and Local Allergy Societies.
Dennis R. Ownby, M.D., Professor of Pediatrics and Internal Medicine, at the Medical College of Georgia and author of the study states in the paper that, "Both household pets and asthma are common in the United States making it highly probable that many persons with asthma live in a home with a pet. Practicing allergists have long known that among those sensitized to animal allergens, exposure to the animal is likely to cause allergic symptoms ranging from mild rhinitis to severe asthma. Even when individuals know that they are allergic to pets, it is common to have a pet in their home. The high costs of asthma care make it is important to ask how much home pet exposure may increase asthma morbidity and related health care costs."
Dr. Ownby concludes that, "There is relatively strong evidence that when individuals with asthma who are allergic to pet allergens live with pets, they require significantly more asthma care. Pet exposure in the home is estimated to result in $0.5 to 1 Billion in extra asthma health care costs. Reducing these excess costs would require that all individuals with asthma be evaluated for allergic sensitivity and then convincing those sensitized to a pet to keep the pet outside of their home."
In an accompanying article, Dr Morris Ling and Aidan Long Morris, of Harvard Medical School, acknowledge that adequate allergen avoidance is difficult to achieve because of the physical characteristics of airborne animal allergens and patient noncompliance. They go on to outline the state of the art care of the patient with pet induced asthma, which includes omalizumab, a monoclonal antibody (Genentech, San Fransisco, CA) which can cost $3,000 per month.
Key findings of the study :
- Approximately 50% of homes have either a cat or dog.
- 17% of the US population is cat allergic
- 7.8% of all persons in the United States have experienced asthma in the preceding 12 months.
- The 2010 estimated cost of asthma in the US is $15.6 billion in direct health care costs.
- Sensitivity to a pet and the relatively constant exposure from having a pet in the home substantially increase asthma morbidity and cost.
- Those with a dog in the home and dog sensitivity had a 49% increase in the risk of needing acute asthma each year of care
- The cost of asthma attributable to indoor pet dander is estimated to be $0.5 to $1 Billion
- $1 Billion in extra asthma health care costs is equal to approximately 0.1% of the total projected health care budget of the United States for 2010.
- Reducing these excess costs would require that all individuals with asthma should be evaluated for allergic sensitivity to thier indoor pets and those allergic, convinced to keep the pet outside of their home.
#1 Title of paper: Pet dander and difficult to control asthma: The burden of illness
Author: Dennis R. Ownby, M.D.,
Professor of Pediatrics and Internal Medicine
Chief, Division of Allergy, Immunology, and Rheumatology
Department of Pediatrics
Medical College of Georgia
There is evidence that allergy to common indoor pets, particularly cats and dogs, is closely associated with symptomatic asthma in the United States. Because the presence of pets in a home is a potentially modifiable factor, it is important to consider how much asthma morbidity and health care cost might be alleviated by the removal of pets from the homes of all persons with pet-allergic asthma. The percentage of pet-associated excess asthma morbidity was estimated as a proportion of all asthma-related health care costs for the United States, which totals $15.6 billion. Therapy for severe pet induced asthma can cost as much as #$3,000 per month.
#2 Title of paper: Pet dander and difficult to control asthma: Therapeutic options
Authors: Morris Ling, M.D.; Aidan A. Long, M.D.From the Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
The prevalence of sensitization to cat and dog allergens is high in the general population and poses a challenge to the physician managing allergic asthma. Adequate allergen avoidance is difficult to achieve because of the physical characteristics of airborne animal allergens and patient noncompliance. Allergen-specific high-dose subcutaneous immunotherapy has shown benefit in cat-allergic patients with asthma and rhinoconjunctivitis, whereas the data for dog-allergic patients are not as convincing. Alternative immunotherapy approaches including the sublingual route or allergen-derived peptide-based immunotherapy remain experimental. Pharmacotherapy of pet-allergic asthmatic patients requires a stepwise approach following established asthma management guidelines. In addition to short-acting beta-agonists and inhaled corticosteroids, prophylactic antihistamines before anticipated pet exposure, the use of intranasal steroids, and the use of leukotriene antagonists may also be considered as adjunctive therapy in pet-allergic patients with asthma and/or allergic rhinitis. Omalizumab appears to have particular efficacy in pet allergen-induced asthma. Novel therapies such as Fcgamma-Fel d 1 chimeric proteins still have to be evaluated in the human setting.
Russell Settipane, MD
Associate Editor, Allergy & Asthma Proceedings