Multicenter prospective observational study of dupilumab-induced ocular events in atopic dermatitis patients

J Eur Acad Dermatol Venereol. 2023 May;37(5):1056-1063. doi: 10.1111/jdv.18932. Epub 2023 Feb 16.

Abstract

Background: Although ocular adverse events are frequent in AD patients treated with dupilumab, their characterization remains limited due to a lack of prospective studies with a systematic ophthalmological examination.

Objective: To examine the incidence, characteristics and risk factors of dupilumab-induced ocular adverse events.

Methods: A prospective, multicenter, and real-life study in adult AD patients treated with dupilumab.

Results: At baseline, 27 out of 181 patients (14.9%) had conjunctivitis. At week 16 (W16), 25 out of 27 had improved their conjunctivitis and 2 remained stable and 34 out of 181 patients (18.7%) had dupilumab-induced blepharoconjunctivitis: either de novo (n = 32) or worsening of underlying blepharoconjunctivitis (n = 2). Most events (27/34; 79.4%) were moderate. A multivariate analysis showed that head and neck AD (OR = 7.254; 95%CI [1.938-30.07]; p = 0.004), erythroderma (OR = 5.635; 95%CI [1.635-21.50]; p = 0.007) and the presence of dry eye syndrome at baseline (OR = 3.51; 95%CI [3.158-13.90]; p = 0.031) were independent factors associated with dupilumab-induced blepharoconjunctivitis.

Limitations: Our follow-up period was 16 weeks and some late-onset time effects may still occur.

Conclusion: This study showed that most dupilumab-induced blepharoconjunctivitis cases are de novo. AD severity and conjunctivitis at baseline were not found to be associated risk factors in this study.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Conjunctivitis* / chemically induced
  • Conjunctivitis* / epidemiology
  • Dermatitis, Atopic* / diagnosis
  • Dermatitis, Atopic* / drug therapy
  • Humans
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • dupilumab
  • Antibodies, Monoclonal, Humanized