16177 Assessment of conjunctivitis occurring in patients with long-term use of dupilumab for the treatment of atopic dermatitis in clinical practice

Abstract

An ongoing safety concern with dupilumab treatment for atopic dermatitis has been the high incidences of conjunctivitis. While incidences of conjunctivitis ranged from 5%-28% in clinical trials, subsequent real-world studies have reported rates of up to 50%. However, implications of the adverse event (AE) with long-term use of dupilumab remains largely unknown. To further characterize conjunctivitis and other ocular surface disorders (OSD) with long-term dupilumab treatment, a retrospective chart review was conducted of consecutive patients receiving dupilumab at two Canadian tertiary hospitals. Fifty-eight patients met inclusion criteria (≥52 weeks of dupilumab or discontinued before 52 weeks due to an OSD) and 2 patients were excluded for missing 52-week appointment data. 21/58 patients (36%) reported conjunctivitis or other OSDs. Onset of symptoms ranged from week 1-32 of treatment, with 17/21 cases (81%) occurring in the first 16 weeks. Despite high incidences of OSDs early on, only 52% of cases resolved, 14% of cases improved, and 24% of cases were ongoing by week 52. Two patients discontinued due to ocular AEs. While one patient discontinued solely due to ocular symptoms at week 48, another discontinued due to watery eyes in conjunction with nonocular symptoms (arthralgia, symmetric numbness) at week 19. Although a majority (81%) of the onset of conjunctivitis occurred in the first 16 weeks, many patients (38%) experienced persistent symptoms even at week 52. Therefore, closer follow-up appointments are recommended to optimize management of patients with ocular symptoms at week 16, as symptoms may persist and impact treatment adherence.