Journal article
Clinical Characteristics and Treatment for Dupilumab-Related Ocular Complications in Atopic Dermatitis Patients
Clinical ophthalmology (Auckland, N.Z.), v 16, pp 947-958
01 Mar 2022
PMID: 35378901
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: Ocular adverse events have been reported in association with dupilumab, a monoclonal antibody to treat allergic diseases including atopic dermatitis (AD). We describe clinical findings and treatment of dupilumab-related ocular complications.
Patients and Methods: Retrospective study of 19 dupilumab-treated AD patients seen for a new ocular complaint. Primary outcomes were specific ocular exam findings (conjunctival injection, corneal fluorescein staining, blepharitis, meibomian gland dysfunction (MGD)), treatments, and follow-up.
Results: Nineteen dupilumab-treated AD patients were included. Median age was 47 years (range 18-73). Over half were women (11/ 19) and majority were Caucasian (13/19). Symptom onset occurred at a mean of 99 days (range 23-520 days) from first dupilumab dose. The most common symptoms were redness (63%), tearing (47%), and pruritus (37%). Most common ocular findings were conjunctival injection (75%) and corneal staining (60%). Blepharitis was seen in about a third (30%), and 25% had MGD. Initially, 10% were observed without treatment, while 15% were treated with artificial tears alone. Other treatments included antihistamine drops (20%) and steroid drops alone (15%). In 40% of patients, a combination of steroids and various other topical eye drops were prescribed. Eighty-four percent (16/19) of patients were seen for follow-up. Steroid drops were required at follow-up in 3 out of 4 patients initially treated with antihistamines alone and in two-thirds of patients initially treated with artificial tears only. Mean follow-up period was 88 days (range 5-369). Dupilumab was discontinued in 31.5% (6/19) of patients; of those who discontinued, 3 restarted it later.
Conclusion: Conjunctival injection was the most frequent dupilumab-related ocular symptom and most common exam finding followed by corneal staining. Most patients initially treated with antihistamine drops or artificial tears alone subsequently required steroid drops to control symptoms. Some patients who discontinued dupilumab restarted the medication after achieving adequate control of ocular symptoms.
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Details
- Title
- Clinical Characteristics and Treatment for Dupilumab-Related Ocular Complications in Atopic Dermatitis Patients
- Creators
- Zujaja Tauqeer - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaStephanie E. Jinno - Drexel UniversityCaroline W. Chung - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaMina Massaro-Giordano - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaVatinee Y. Bunya - Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania
- Publication Details
- Clinical ophthalmology (Auckland, N.Z.), v 16, pp 947-958
- Publisher
- Dove Medical Press Ltd
- Number of pages
- 12
- Grant note
- R01 EY026972 / National Eye Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI) Research to Prevent Blindness; Research to Prevent Blindness (RPB)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000783714800002
- Scopus ID
- 2-s2.0-85128078003
- Other Identifier
- 991021861300104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology