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

Abstract

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. To examine the incidence, characteristics and risk factors of dupilumab-induced ocular adverse events. A prospective, multicenter, and real-life study in adult AD patients treated with dupilumab. 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. Our follow-up period was 16 weeks and some late-onset time effects may still occur. 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.