Double-blind placebo-controlled house dust mite control measures in adult patients with atopic dermatitis

Gutgesell, C.; Heise, S.; Seubert, S.; Seubert, Andreas; Domhof, Sebastian; Brunner, Edgar; Neumann, Ch.

doi:10.1046/j.1365-2133.2001.04283.x

Cited by 104 publications

(70 citation statements)

References 18 publications

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“…All three trials [367][368][369] failed to show any benefit of house dust mite reduction interventions for eczema compared with placebo or normal cleaning practices over a period of up to 12 months. The trial by Ricci and colleagues 369 showed a mean decrease in SCORAD scores from 33 to 24 in the first month for the mite avoidance group compared with a mean decrease from 27 to 22 in the placebo group.…”

Section: Benefitsmentioning

confidence: 99%

“…Three new trials [367][368][369] have been reported since 2000. Ricci and colleagues 369 randomised a group of 41 children aged from 2 to 10 years and sensitised to food or inhalant allergens to either 'recommended' house dust mite reduction measures (mattress and pillow encasings, hot wash of bedding at least once a week, vacuuming the living room and bedroom at least twice a week, carpets vacuumed at least once a week or removed and no pets) or no recommendations (normal cleaning patterns) for 2 months.…”

Section: Studiesmentioning

confidence: 99%

“…The third trial by Gutgesell and colleagues 367 randomised only 20 participants with eczema and sensitised to house dust mite to either allergen-impermeable polyurethane encasings and acaricide (mite-killing) spray made up of tannic acid and benzyl benzoate or cotton 'placebo' encasings and 'placebo' acaricide spray (water with traces of ethanol) for a year. The severity of eczema was assessed using the SCORAD index; daytime pruritus and pruritus-induced sleeplessness were assessed using a VAS, and participant-assessed skin status and the amount of topical corticosteroids used were both recorded.…”

Section: Studiesmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Benefitsmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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“…Although intensively discussed, evidences are still scarce when attempting to relate the onset of AE to the environmental exposure to dust mites, the principal allergens in household dust. 1,18 Randomized essays on environmental control measures for dust mites have depicted conflicting results in the clinical improvement of AE patients 19,20 and there are almost no cross cut studies relating AE with higher household dust mites' levels. 21 On the other hand, it is known that dust mites antigens are capable of crossing the epidermis and causing a specific immune response in the skin of individuals with AE.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for atopic eczema in school children

Wandalsen

Camelo-Nunes

Mello

et al. 2005

Rev. Bras. Saude Mater. Infant.

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Objectives: to study risk factors related to atopic eczema (AE) in school children of São Paulo.Methods: 1972 parents or guardians of 6-7 years old children in the Southern Central area of São Paulo answered to a written questionnaire (standardized questionnaire of the International Study of Asthma and Allergies in Childhood plus a complementary questionnaire regarding family history of asthma and allergies, and exposure to environmental allergens). AE was defined by the presence of an itchy rash in the last year. Risk factors were analyzed through logical regression.Results: the following factors were significantly associated with AE: history of maternal (OR: 4

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“…46,47 Thus avoidance of food allergens and limiting exposure to aeroallergens may help in reducing the symptoms of AD.…”

Section: Clinical Correlations Of Recent Developments In the Pathogenmentioning

confidence: 99%

Clinical correlations of recent developments in the pathogenesis of atopic dermatitis

Sehra

Tuana

Holbreich

et al. 2008

An. Bras. Dermatol.

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Atopic dermatitis is a chronic inflammatory skin disease with a steadily increasing prevalence affecting 10-20 % of infants and 1-3% of adults globally. It is often the first clinical manifestation of atopic disease preceding asthma and allergic rhinitis. Probably half of the children with atopic dermatitis develop some other form of atopic disease later in life. The pathogenesis involves a complex interplay of factors including genetic predisposition due to altered immune or skin barrier function, interactions with the environment such as food and allergen exposures, and infectious triggers of inflammation. In this review, we summarize the recent advances in understanding the contribution of different factors in the pathophysiology of atopic dermatitis and how insights provide new therapeutic potential for its treatment. Keywords: Asthma; Atopic Dermatitis, Eczema; Eosinophils; Genetics; Immunoglobulin E; Keratinocytes; Rhinitis, T-Lymphocytes Resumo: A dermatite atópica é uma doença cutânea inflamatória crônica cuja prevalência tem aumentado de forma constante, afetando 10-20% dos lactentes e 1-3% dos adultos em todo o mundo. Ela é freqüentemente a primeira manifestação clínica de doença atópica, precedendo a asma e a rinite alérgica. Provavelmente metade das crianças com dermatite atópica desenvolvem alguma

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Double-blind placebo-controlled house dust mite control measures in adult patients with atopic dermatitis

Abstract: For adult patients with atopic dermatitis it was shown that 1 year of house dust mite avoidance reduced the allergen exposure, but an improvement of overall disease activity was not demonstrated.

Cited by 104 publications

References 18 publications

Scoping systematic review of treatments for eczema

Scoping systematic review of treatments for eczema

Risk factors for atopic eczema in school children

Clinical correlations of recent developments in the pathogenesis of atopic dermatitis

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