Are There Effective Methods to Reduce Exposure to House Dust Mite Allergens? A Meta-Analysis of Randomized Clinical...

House dust mites (HDMs) are the most common cause of atopic sensitivities and allergic diseases worldwide. Therefore, we decided to conduct a meta-analysis of randomized clinical trials to evaluate the effect of different methods of HDM avoidance.

PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched to find articles of control-compared randomized clinical trials, which investigated the following analyzed outcomes: total amount of dust (g); Der1 (Der p1 plus Der f1) concentrations (µg/g); Der p1 concentrations (µg/g); Der p2 concentrations (µg/g); Der f1 concentrations (µg/g); measurements of peak expiratory flow (PEF) (L/min); respiratory, pulmonary, or nasal symptoms according to various scales, including visual analog scale; exacerbations; Asthma Control Questionnaire score measurements; and change in quality of life scales (overall change, activity change, symptom change, and emotional function change). The relative risk with 95% confidence interval (CI) and the mean difference or the standardized mean difference with 95% CI were calculated to compare the effect. A random effects model was used to calculate effect sizes.

Our meta-analysis was based on 17 studies. We indicated the significant differences between interventional and control groups in total amount of dust (MD = ‒0.24; 95% CI [‒0.37; ‒0.11]; p < 0.001; I² = 57%) and Der1 (Der p1 plus Der f1) concentrations (MD = ‒0.97; 95% CI [‒1.81; ‒0.13]; p = 0.02; I² = 82%). However, they are not sufficient to improve diseases, such as asthma and allergic rhinitis, or to improve the quality of life of patients.

HDM allergen avoidance methods are effective in reducing dust and Der1 concentrations.