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House dust mite control measures for asthma: systematic review
Author(s) -
Gøtzsche P. C.,
Johansen H. K.
Publication year - 2008
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2008.01690.x
Subject(s) - medicine , asthma , confidence interval , house dust mite , mite , placebo , randomized controlled trial , relative risk , strictly standardized mean difference , psychological intervention , meta analysis , allergen , allergy , physical therapy , immunology , alternative medicine , botany , pathology , psychiatry , biology
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.