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Review
. 2020 Jun 19;20(9):50.
doi: 10.1007/s11882-020-00948-y.

Update on House Dust Mite Allergen Avoidance Measures for Asthma

Chiara Zuiani  1 , Adnan Custovic  2   3
Affiliations
Review

Update on House Dust Mite Allergen Avoidance Measures for Asthma

Chiara Zuiani et al. Curr Allergy Asthma Rep. .

Abstract

Purpose of review: To critically review the evidence in favor or against the use of house dust mite (HDM) allergen avoidance measures in patients with asthma.

Recent findings: Systematic reviews and meta-analyses suggested no positive effect of mite allergen avoidance strategies on asthma outcomes, resulting in a lack of consensus regarding the utility of these measures. However, such analyses have a number limitations and might not be the most adequate tool to evaluate current evidence and to derive clinical recommendations regarding mite allergen avoidance in asthmatic patients. We should not disproportionately rely on the results of meta-analyses and systematic reviews to inform clinical practice and asthma guidelines in this area. Recent high-quality evidence from randomized controlled trial in children confirmed that mite allergen-impermeable bed encasings reduce emergency hospital attendance with acute severe asthma exacerbations. Until better evidence is available, we suggest that physicians should adopt a pragmatic approach to mite allergen avoidance and advise sensitized patients to implement a multifaceted set of measures to achieve as great a reduction in exposure as possible. Potential predictors of positive response (e.g., patient's sensitization and exposure status) can pragmatically be evaluated using the size of skin test wheal or the titer of allergen-specific IgE. Finally, the intervention should be started as early as possible.

Keywords: Allergen; Asthma; Avoidance; Exposure; House dust mite; Mite.

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Conflict of interest statement

Dr. Custovic reports personal fees from Novartis, personal fees from Thermo Fisher Scientific, personal fees from Philips, personal fees from Sanofi, and personal fees from Stallergenes Greer, outside the submitted work. Dr. Zuiani declares no conflict of interest relevant to this manuscript.

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