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Tuesday, July 20, 2010

Dust mite allergy and perennial allergic rhinitis

The most significant contributor to perennial allergic rhinitis (PAR) is dust mite allergy. Reducing exposure to house dust mite seems like an obvious strategy to minimize symptoms in PAR patients, but does it work? In a 2010 update to a Cochrane Review, Sheikh et al. (Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD001563. DOI: 10.1002/14651858.CD001563.pub3) re-examine the literature to see if anyone else is trying to add more insight into this question. The authors searched the same 4 databases, two Cochrane, Medline and EMBASE, for newly published, randomized trials that evaluate air filtration, pesticides, and barrier bedding as mitigation.

Nine trials of varying quality met inclusion criteria. They didn’t find sufficient numbers and/or rigorously designed trials to permit a meta-analysis, so the authors provide a narrative of their findings. Overall the studies’ results suggest that acaricides along with extensive environmental control via air filtration seem to offer some benefit, but it’s uncertain which method is most effective and to what degree. Sheikh and colleagues are able to state that the evidence is strong that the single intervention of barrier bedding in the patient’s room is not likely to be helpful.

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