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Ocular Surface Disease

Incidence and treatment of dupilumab-induced OSD in patients with atopic dermatitis

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Dupilumab-induced ocular surface disease (DIOSD) is not uncommon among patients with atopic dermatitis (AD) who are receiving dupilumab treatment, according to a study that found that with timely referral and appropriate topical treatment, better clinical outcomes and patient satisfaction can be achieved without the need to discontinue dupilumab.

The study, based on a prospective case series, included 113 patients with AD who developed ocular symptoms after initiating dupilumab treatment. Out of these patients, 32 (28.31%) were diagnosed with DIOSD. Among the individuals with DIOSD, 20 (62.5%) were referred to a cornea service for specialized care.

The onset of ocular symptoms after initiating dupilumab treatment occurred, on average, at around 9.2 weeks. Nearly 90% of the patients presented with bilateral conjunctival inflammation and blepharitis, indicating the involvement of the ocular surface.

In response to the standard treatment protocol, which included topical eye treatments, patients demonstrated significant improvements in both subjective symptom severity and objective measures, such as the Ocular Surface Disease Index (OSDI) score. The OSDI score decreased from an average of 34.0 to 10.2, indicating a positive response to the treatment.

None of the patients had to discontinue dupilumab due to DIOSD.

Reference
Pradhan SP, Sadiq SN, Cartes C, et al. Dupilumab induced ocular surface disease: A prospective case series. Eur J Ophthalmol. 2023;11206721231199155. doi: 10.1177/11206721231199155. Epub ahead of print. PMID: 37644849.

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