The effectiveness of reducing house dust mite (HDM) antigen levels in the environment of asthmatic children was assessed in a systematic review. An electronic search identified 25 randomized controlled trials (RCT) that were included in a meta-analysis. We analyzed O1: Subjective symptom improvement; O2: Asthma symptom scores; O3: Medication usage; O4: Days of sick-leave from school or work; O5: Number of unscheduled physician or hospital visits; O6: FEV1 (forced expiratory volume in one second); O7: PEFR (peak expiratory flow rate); O8: PC20 (provocative concentration causing a 20% decrease in FEV1); and O9: FeNO (fractional exhaled concentration of nitric oxide). For O3, O5 and O7, intervention to reduce HDM antigen showed a significant beneficial effect, but O3 and O5 were referenced in only one study. No significant effect of interventions was seen for the other outcomes. Our results suggest that intervention to reduce HDM antigen levels in the environment of asthmatic children does not have a significant effect. However, given the variety of the climatic conditions and life-style of the countries that were the focus of studies included in our meta-analysis, careful interpretation is needed and questions should be addressed to determine whether these results are applicable to Japan.
"},{"@language":"ja","@value":"ダニに感作のある小児気管支喘息患者に対して，ダニの抗原回避の有用性をシステマティックレビュー（SR）で検討した．先行したコクランレビューでのSRから小児を対象とする無作為化比較試験（RCT）を抽出し，先行SR以降のRCTを文献データベースから抽出した．先行SRから18文献，新規に7文献を抽出し，O1：主観的な症状，O2：喘息症状スコア，O3：薬剤使用量，O4：学校や仕事を喘息症状が原因で休んだ日数，O5：予定外の受診回数，O6：1秒量，O7：ピークフロー，O8：気道過敏性試験，O9：呼気中一酸化窒素濃度についてメタ解析を行った．O3，O5，O7で介入群に有意で有効な結果となったが，O3・O5は解析対象文献が1つであり，その他のアウトカムは有意差を認めず，ダニ抗原曝露減少を推奨する強い根拠は存在しなかった．しかし，採用した論文のうち本邦のものは1文献のみであり，環境の異なる海外の結果がそのまま該当するか，十分に検討する必要がある．今後本邦でのエビデンスが蓄積されることを期待する．
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