Dust-mite inducing asthma: what advice can be given to patients?

Abstract:

:Introduction: Amongst allergic asthmatics, high allergen exposure increases asthma severity. However, there is no consensus on the role of mite allergen avoidance in the management of asthma, and various guidelines differ in their recommendations. Areas covered: Several systematic reviews/meta-analyses on mite avoidance in the management of asthma have been published, and their findings have been used for a call to provide a recommendation in British guidelines that dust-mite control measures should not be recommended. However, there are several problems with such analysis (such as combining studies in adults and children), and we question whether these are appropriate tools to evaluate available evidence about mite allergen avoidance, and whether it is correct to rely disproportionately on the results of meta-analyses/systematic reviews to inform clinical practice in this area. Recent evidence in children suggests that mite-impermeable bed encasings reduce emergency hospital attendance with severe asthma exacerbations. Expert opinion: The practical questions include how to achieve a sufficient real-life reduction allergen exposure, and how to identify patients who will benefit from effective intervention. The intervention should start early in the natural history of asthma, and consideration for choosing patients should include using the titre of allergen-specific IgE antibodies or the size of skin test wheal as an indicator.

journal_name

Expert Rev Respir Med

authors

Custovic A,Murray CS,Simpson A

doi

10.1080/17476348.2019.1651647

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

929-936

issue

10

eissn

1747-6348

issn

1747-6356

journal_volume

13

pub_type

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