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. Author manuscript; available in PMC: 2020 Jun 10.
Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE IX.A.1.

Evidence of the effectiveness of house dust mite avoidance and environmental controls in the management of allergic rhinitis

Study Year LOE Study design Study groups Clinical endpoint Conclusion
Sheikh et al.1126 2010 1a SR RCTs examining the effectiveness of environmental measures for HDM Symptoms Acaricides are the most effective as a single measure or in combination with other measures to decrease HDM and improve symptoms.
Ghazala et al.1120 2004 1b Randomized crossover study

  1. Adults with atopy and use of impermeable encasings;

  2. Adults with atopy without use of impermeable encasings

 Allergen content (Der p 1, Der f 1, mite group 2), subjective clinical complaints Impermeable encasings significantly reduce allergen concentration, without difference in subjective symptom scores.
Terreehorst et al.1124 2003 1b Double-blind RCT

  1. Children with atopy and HDM impermeable bedding;

  2. Children with atopy without HDM impermeable bedding

 Rhinitis-specific visual analogue scale, daily symptom score, nasal allergen provocation, Der p 1 and Der f 1 concentration Impermeable encasings significantly reduce allergen concentration, without difference in symptoms or nasal provocation testing.
Nurmatov et al.1114 2012 2a SR of RCTs

  1. Use of HDM impermeable bedding (n = 4);

  2. Acaricides (n = 2);

  3. HEPA filtration (n = 2);

  4. Acaricides and HDM impermeable bedding in isolation and combination (n = 1)

 HDM load, symptom scores, medication scores, disease-specific QOL Environmental controls significantly reduced HDM load. Acaricides most effective single method. Combination therapies more effective than single interventions and may offer symptom relief.
Stillerman et al.1127 2010 2b RDBPCT, crossover

  1. Adults with atopy and PAF;

  2. Same adults with atopy, without PAF

 Reported nasal symptoms, QOL scores using the nocturnal RQLQ PAF is associated with improved nasal symptom and QOL scores.
Brehler & Kneist1128 2006 2b RDBPCT, parallel-group

  1. Children with atopy and HDM-impermeable bedding;

  2. Children with atopy without HDM-impermeable bedding

 Allergy symptom scores, use of anti-allergic medication HDM-impermeable bedding is associated with significant reduction in symptom scores without change in anti-allergic drug utilization.
Moon & Choi1122 1999 2b Open RCT

  1. Adults and children with atopy and multimodality environmental control;

  2. Adults and children with atopy and verbal advice on allergen avoidance

 Change in HDM load, daily rhinitis symptom scores Multimodality environmental control is associated with reductions in mean dust mite concentration and nasal symptom scores.
Geller-Bernstein et al.1119 1995 2b Double-blind RCT

  1. Children with atopy, bedroom sprayed with acaricide;

  2. Children with atopy without acaricide

 Daily rhinitis and asthma symptom scores, medication use, twice-weekly PEF Acaricide is associated with decreased mean symptom scores.
Kniest et al.1121 1992 2b Double-blind matched pair controlled trial

  1. Adults and children with atopy and intensive home cleaning plus acaricide;

  2. Adults and children with atopy and intensive home cleaning alone

 Daily symptoms and medication scores, physician assessment, tIgE, sIgE, serum and nasal eosinophils, guanine exposure Acaricide associated with improvement in all outcome measures except for mite-specific IgE.
Antonicelli et al.1125 1991 2b Randomized crossover study

  1. Adults and children with atopy and HEPA filtration;

  2. Adults and children with atopy without HEPA filtration

 HDM concentration, rhinitis and asthma symptom score HEPA filtration had no significant effect on rhinitis symptom scores.
Reisman et al.1123 1990 2b Double-blind crossover RCT

  1. Adults with atopy and HEPA filtration;

  2. Adults with atopy and placebo filtration

 Particulate counts in bedroom air, symptom and medication scores, patients’ subjective response to treatment HEPA filtration is associated with improved particulate counts and symptom/medication scores.

HDM = house dust mite; HEPA = high-efficiency particulate air; IgE = immunoglobulin E; LOE = level of evidence; PAF = personal air filtration; PEF = peak expiratory flow; QOL = quality of life; RCT = randomized controlled trial; RDBPCT = randomized double-blind-placebo-controlled trial; RQLQ; Rhinoconjunctivitis Quality of Life Questionnaire; sIgE = antigen specific immunoglobulin E; SR = systematic review; tIgE = total immunoglobulin E.