Article : Can Allergen Avoidance Prevent Asthma Exacerbations?

David J. Amrol, MD reviewing Murray CS et al. Am J Respir Crit Care Med 2017 Jul 15.

In sensitized children, dust mite coverings reduced emergency visits.

While viral infections trigger most childhood asthma exacerbations, allergens play a central role in airway inflammation and hyper-responsiveness. Allergen avoidance is a cornerstone for managing allergic disease, but evidence supporting its role in reducing asthma exacerbations is lacking.

In a double-blind U.K. study, 284 dust mite–sensitized children (ages 3–17 years) with asthma and a recent exacerbation requiring an urgent visit were randomized to receive mite-impermeable or control bed coverings. Dust mite levels in the children's mattresses were reduced by 84% in the mite-cover group and were unchanged in the control group. At 12 months, 29% of children in the mite-cover group had a severe exacerbation (requiring systemic steroids and emergency department [ED] or hospital visit) versus 42% of control patients. The risk for an ED visit was 45% lower in the mite-cover group.


Murray CS et al. Preventing severe asthma exacerbations in children. A randomized trial of mite-impermeable bedcovers. Am J Respir Crit Care Med 2017 Jul 15; 196:150.