House dust mite control measures for asthma: systematic review

• Published in: Allergy Vol. 63; no. 6; pp. 646 - 659
• Main Authors: Gøtzsche, P.C, Johansen, H.K
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.06.2008; Blackwell Publishing Ltd; Blackwell
• Subjects: Allergens - immunology; Animals; Asthma; Asthma - etiology; Asthma - immunology; Asthma - prevention & control; Bedding and Linens; Biological and medical sciences; Clinical trials; Dermatophagoides pteronyssinus; Dust; Dust - immunology; dust mites; Environmental Exposure - prevention & control; Fundamental and applied biological sciences. Psychology; Fundamental immunology; house dust mites; Humans; Insecticides; Insects; Medical sciences; Pest control; Pest Control - methods; Pyroglyphidae - immunology; Randomized Controlled Trials as Topic; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; systematic review; Lung disease; Immunopathology; Respiratory disease; Dermatology; Evidence-based practice; House dust; Mite; Systematic review; Evidence-based medicine; Asthma; house dust mites; Immunology; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0105-4538; 1398-9995; 0108-1675
• DOI: 10.1111/j.1398-9995.2008.01690.x

The major allergen in house dust comes from mites. We performed a systematic review of the randomized trials that had assessed the effects of reducing exposure to house dust mite antigens in the homes of people with mite-sensitive asthma, and had compared active interventions with placebo or no treatment. Fifty-four trials (3002 patients) were included. Thirty-six trials assessed physical methods (26 mattress covers), 10 chemical methods and eight a combination of chemical and physical methods. Despite the fact that many trials were of poor quality and would be expected to exaggerate the reported effect, we did not find an effect of the interventions. For the most frequently reported outcome, peak flow in the morning (1565 patients), the standardized mean difference was 0.00 (95% confidence interval (CI) -0.10 to 0.10). There were no statistically significant differences in number of patients improved (relative risk 1.01, 95% CI 0.80-1.27), asthma symptom scores (standardized mean difference -0.04, 95% CI -0.15 to 0.07) or in medication usage (standardized mean difference -0.06, 95% CI -0.18 to 0.07). Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended.