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

• Published in: Journal of the European Academy of Dermatology and Venereology 2023-05, Vol.37 (5), p.1056-1063
• Main Authors: Costedoat, Ingrid, Wallaert, Martin, Gaultier, Aurelie, Vasseur, Robin, Vanhaecke, Clelia, Viguier, Manuelle, Cordelette, Charles, Denoyer, Alexandre, Ferrier le Bouëdec, Marie‐Christine, Coutu, Adrien, Lamiaux, Marie, Tran, Thi Ha Châu, Lacour, Jean Philippe, Elmaleh, Valerie, Tetart, Florence, Gueudry, Julie, Tauber, Marie, Giordano‐Labadie, Francoise, Cassagne, Myriam, Nosbaum, Audrey, Ouilhon, Coralie, Jachiet, Marie, Tadayoni, Ramin, Dezoteux, Frederic, Staumont‐Salle, Delphine, Bouleau, Julien, Labalette, Pierre, Doan, Serge, Soria, Angele, Mortemousque, Bruno, Seneschal, Julien, Barbarot, Sebastien
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Monoclonal, Humanized - adverse effects; Conjunctivitis - chemically induced; Conjunctivitis - epidemiology; Dermatitis, Atopic - diagnosis; Dermatitis, Atopic - drug therapy; Humans; Life Sciences; Prospective Studies; Severity of Illness Index; Treatment Outcome
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/jdv.18932

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.