Dust mite avoidance for the primary prevention of atopic dermatitis: A systematic review and meta-analysis

Samuel F. Bremmer, Eric Simpson

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Dust mite sensitization plays a controversial role in the development of atopic dermatitis. Despite a lack of evidence for its efficacy, dust mite avoidance is commonly recommended for the prevention and treatment of atopic dermatitis. We aimed to evaluate whether dust mite avoidance strategies reduce the risk of developing atopic dermatitis in high-risk infants compared to randomized controls. Methods: Studies were obtained by searching MEDLINE, PubMed, Scopus, The Cochrane Library, and The Global Resource of Eczema Trials databases. We included randomized, controlled trials of high-risk infants treated with a dust mite avoidance intervention and assessed for atopic dermatitis. Data were extracted independently by two reviewers using predefined criteria. Results: Seven randomized controlled trials met our inclusion criteria (total n = 3040). Studies were largely unblinded but otherwise of reasonable quality. Three trials utilizing a dust mite avoidance approach but not additional interventions were combined in a meta-analysis. Dust mite avoidance provided no benefit in the prevention of atopic dermatitis (relative risk (RR) = 1.08, 95% confidence interval (CI) = 0.78-1.49, I2 = 73%). Conclusions: Dust mite avoidance strategies alone or in combination with additional allergen avoidance modalities do not decrease the risk of developing atopic dermatitis and, given the current state of the evidence, should not be recommended for this purpose. The utility of dust mite avoidance for the treatment of atopic dermatitis or for the prevention and treatment of asthma or seasonal rhinoconjunctivitis are outside the scope of this review.

Original languageEnglish (US)
Pages (from-to)646-654
Number of pages9
JournalPediatric Allergy and Immunology
Volume26
Issue number7
DOIs
StatePublished - Nov 1 2015

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Mites
Atopic Dermatitis
Primary Prevention
Dust
Meta-Analysis
Randomized Controlled Trials
Eczema
PubMed
MEDLINE
Allergens
Libraries
Therapeutics
Asthma
Databases
Confidence Intervals

Keywords

  • Atopic dermatitis
  • Dust mite
  • Meta-analysis
  • Prevention
  • Randomized controlled trial
  • Systematic review

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health
  • Immunology

Cite this

Dust mite avoidance for the primary prevention of atopic dermatitis : A systematic review and meta-analysis. / Bremmer, Samuel F.; Simpson, Eric.

In: Pediatric Allergy and Immunology, Vol. 26, No. 7, 01.11.2015, p. 646-654.

Research output: Contribution to journalArticle

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