House dust mite control measures in the management of XXXX : meta-analysis.

@entity1 @entity565 @entity1109 @entity56
OBJECTIVE: To determine whether @entity1 with @entity565 who are sensitive to mites benefit from measures designed to reduce their exposure to house dust mite antigen in the home. DESIGN: Meta-analysis of randomised trials that investigated the effects on @entity565 @entity1 of chemical or physical measures to control mites, or both, in comparison with an untreated control group. All trials in any language were eligible for inclusion. SUBJECTS: @entity1 with @entity565 as diagnosed by a doctor and sensitisation to mites as determined by skin prick testing, bronchial provocation testing, or serum assays for specific IgE antibodies. MAIN OUTCOME MEASURES: Number of @entity1 whose @entity56 symptoms improved, improvement in @entity1109 , improvement in peak expiratory flow rate. Outcomes measured on different scales were combined using the standardised effect size method (the difference in effect was divided by the standard deviation of the measurements). RESULTS: 23 studies were included in the meta-analysis; 6 studies used chemical methods to reduce exposure to mites, 13 used physical methods, and 4 used a combination. Altogether, 41/113 @entity1 exposed to treatment interventions improved compared with 38/117 in the control groups (odds ratio 1.20, 95% confidence interval 0.66 to 2.18). The standardised mean difference for improvement in @entity1109 was -0.06 (95% confidence interval -0.54 to 0.41). For peak flow rate measured in the morning the standardised mean difference was -0.03 (-0.25 to 0.19). As measured in the original units this difference between the treatment and the control group corresponds to -3 l/min (95% confidence interval -25 l/min to 19 l/min). The results were similar in the subgroups of trials that reported successful reduction in exposure to mites or had long follow up times. CONCLUSION: Current chemical and physical methods aimed at reducing exposure to allergens from house dust mites seem to be ineffective and cannot be recommended as prophylactic treatment for @entity565 @entity1 sensitive to mites.
