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PICO question

In horses with severe equine asthma syndrome, is inhaled immunotherapy compared to environmental reduction of allergen exposure more effective in disease modification?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

12 papers were critically reviewed. Nine clinical trials; one crossover study; one split-plot design study; and one cross-sectional study

Strength of evidence


Outcomes reported

Four studies found inhaled immunotherapy to improve the clinical signs associated with equine asthma and the lung function of horses with asthma. Three papers found environmental modification improved lung function and the clinical signs associated with equine asthma but two studies provide moderate evidence that environmental management alone is insufficient to permanently cure asthma


There is a low level of evidence to support the use of inhaled immunotherapy as a treatment for equine asthma


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed