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Meta-Analysis
. 2008 Apr 16;2008(2):CD001187.
doi: 10.1002/14651858.CD001187.pub3.

House dust mite control measures for asthma

P C Gøtzsche  1 , H K Johansen
Affiliations
Meta-Analysis

House dust mite control measures for asthma

P C Gøtzsche et al. Cochrane Database Syst Rev. .

Abstract

Editorial note: This 2011 review predates current reporting standards and methodological expectations for Cochrane Reviews. It should not be used for clinical decision‐making.

Background: The major allergen in house dust comes from mites. Chemical, physical and combined methods of reducing mite allergen levels are intended to reduce asthma symptoms in people who are sensitive to house dust mites.

Objectives: To assess the effects of reducing exposure to house dust mite antigens in the homes of people with mite-sensitive asthma.

Search strategy: PubMed and The Cochrane Library (last searches Nov 2007), reference lists.

Selection criteria: Randomised trials of mite control measures vs placebo or no treatment in people with asthma known to be sensitive to house dust mites.

Data collection and analysis: Two authors applied the trial inclusion criteria and evaluated the data. Trial authors were contacted to clarify information.

Main results: Fifty-four trials (3002 patients) were included. Thirty-six trials assessed physical methods (26 mattress encasings), 10 chemical methods, and 8 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 standardised mean difference was 0.00 (95% confidence interval (CI) -0.10 to 0.10). There were no statistically significant differences either in number of patients improved (relative risk 1.01, 95% CI 0.80 to 1.27), asthma symptom scores (standardised mean difference -0.04, 95% CI -0.15 to 0.07), or in medication usage (standardised mean difference -0.06, 95% CI -0.18 to 0.07).

Authors' conclusions: Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended. It is doubtful whether further studies, similar to the ones in our review, are worthwhile. If other types of studies are considered, they should be methodologically rigorous and use other methods than those used so far, with careful monitoring of mite exposure and relevant clinical outcomes.

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Conflict of interest statement

None.

Figures

1
1
'Risk of bias' summary: review authors' judgements about allocation concealment for each included study.
1.1
1.1. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 1: Numbers improved
1.2
1.2. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 2: Asthma symptoms score
1.3
1.3. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 3: Medication usage
1.4
1.4. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 4: FEV1 (forced expiratory volume in one second)
1.5
1.5. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 5: PEFR morning (Peak Expiratory Flow Rate)
1.6
1.6. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 6: PEFR evening (Peak Expiratory Flow Rate)
1.7
1.7. Analysis
Comparison 1: House dust mite reduction versus control, Outcome 7: PC20 (provocative concentration for 20% fall in FEV1)
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

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References to studies excluded from this review

Bowler 1985 {published data only}
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Brown 1991 {published data only}
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Elixmann 1988 {published data only}
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Gallardo 1994 {published data only}
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Glasgow 2011 {published data only}
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Hannaway 1993 {published data only}
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