June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Clinical characteristics and treatment for dupilumab-related ocular complications in atopic dermatitis patients
Author Affiliations & Notes
  • Stephanie E. Jinno
    Drexel University College of Medicine, Philadelphia, Pennsylvania, United States
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Caroline W. Chung
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Zujaja Tauqeer
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Mina Massaro-Giordano
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Vatinee Y Bunya
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Stephanie Jinno, None; Caroline Chung, None; Zujaja Tauqeer, None; Mina Massaro-Giordano, Lynthera (C), PRN Nutraceuticals (I); Vatinee Bunya, Bausch & Lomb--grant support (F), EP 3210201 (P), National Eye Institute: R01 EY026972 (F), Research to Prevent Blindness (F), US 10,360,819 (P), US 10,783,505 (P)
  • Footnotes
    Support  National Eye Institute: R01 EY026972
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1237. doi:
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      Stephanie E. Jinno, Caroline W. Chung, Zujaja Tauqeer, Mina Massaro-Giordano, Vatinee Y Bunya; Clinical characteristics and treatment for dupilumab-related ocular complications in atopic dermatitis patients. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1237.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Ocular adverse events have been reported in association with dupilumab, a monoclonal antibody therapy to treat allergic diseases including atopic dermatitis (AD). We sought to describe clinical findings and treatment for dupilumab-related ocular complications.

Methods : Retrospective case series of 20 dupilumab-treated AD patients seen for a new ocular complaint in an academic ophthalmology practice. Primary outcomes were specific ocular exam findings (conjunctival injection, eyelid dermatitis, corneal fluorescein staining, blepharitis, or meibomian gland dysfunction (MGD)) and treatments prescribed at the initial visit and follow-up visits.

Results : A total of 20 dupilumab-treated AD patients were included. The mean age was 47 years (range 18-73), with over half being women (55%) and the majority Caucasian (70%). Symptom onset occurred at a mean of 101 days (SD=109, 95% CI: 49.91 to 151.79) from the first dupilumab dose. The most common ocular findings were conjunctival injection (75%) and corneal staining (60%). Blepharitis was seen in about a third (30%) of patients and 25% had MGD. After the initial visit, 10% were observed without treatment, while 15% patients were treated with artificial tears (AT) 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. Out of the 20 patients, 17 were seen in 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 AT only. Mean follow-up period was 89 days (range 5-369). Dupilumab was discontinued in 7 out of 20 patients; of those who discontinued, 3 were able to restart it later.

Conclusions : Conjunctival injection was the most frequent dupilumab-related ocular complication observed followed by corneal staining. The majority of patients initially treated with antihistamines or AT alone subsequently required steroid drops to control symptoms. Some patients who discontinued dupilumab were able to restart the medication after achieving adequate control of their ocular symptoms. Future larger studies are needed to confirm the incidence of dupilumab-related ocular complications, identify risk factors, and compare treatment outcomes.

This is a 2021 ARVO Annual Meeting abstract.

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