House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review

Authors

  • U. Nurmatov,

    1. Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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  • C. P. van Schayck,

    1. Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
    2. Department of General Practice, CAPHRI, Maastricht University, Maastricht, The Netherlands
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  • B. Hurwitz,

    1. Division of Health and Social Care Research, Department of English Language and Literature, King’s College London, London, UK
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  • A. Sheikh

    1. Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
    2. Department of General Practice, CAPHRI, Maastricht University, Maastricht, The Netherlands
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  • Edited by: Thomas Bieber

Prof. Aziz Sheikh, Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK.
Tel.: +44 (0)131-651-4151
Fax: +44 (0)131-650-9119
E-mail: aziz.sheikh@ed.ac.uk

Abstract

To cite this article: Nurmatov U, van Schayck CP, Hurwitz B, Sheikh A. House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review. Allergy 2012; 67: 158–165.

Abstract

Background:  To assess the benefits and harms of measures designed to reduce house dust mite (HDM) exposure in the management of house dust mite–sensitive allergic rhinitis.

Methods:  Systematic review of randomized controlled trials was made, in which HDM control measures have been evaluated in comparison with placebo or other HDM avoidance measures, in patients with clinically proven allergic rhinitis.

Results:  Nine trials involving 501 participants satisfied the inclusion criteria. These trials have investigated the effectiveness of bedroom environmental control programmes involving the use of HDM impermeable bedding covers (n = 4), acaricides (n = 2), high-efficiency particulate air filters (n = 2) and, using a factorial design, acaricide and HDM impermeable bedding covers in isolation and combination (n = 1). Seven of the nine trials reported that, when compared with control, the interventions studied resulted in significant reductions in HDM load. Of the interventions studied to date, acaricides appear to be the most promising, although the findings from these studies need to be interpreted with care because of their methodological limitations. House dust mite impermeable bedding as an isolated intervention is unlikely to offer benefit.

Conclusions:  Trials have tended to be small and of poor methodological quality, making it difficult to offer any definitive recommendations. Interventions that achieve substantial reductions in HDM load may offer some benefit in reducing rhinitis symptoms. Isolated use of HDM impermeable bedding is unlikely to prove effective.

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