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  • Conjunctivitis Secondary to Dupilumab Treatment of Atopic Dermatitis

    By Lynda Seminara
    Selected By: Deepak P. Edward, MD
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    Journal Highlights

    JAMA Dermatology
    Published online Aug. 29, 2018

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    Treister et al. set out to pinpoint risk factors for conjunctivitis among patients with dupilumab-treated atopic derma­titis (AD). They found the strongest predictors to be severe AD at baseline and the presence of a concomitant atopic disorder.

    From a cohort of 142 patients who received dupilumab for AD, conjuncti­vitis occurred in 12 (8.5%). Dupilumab exposure consisted of a 600-mg loading dose, followed by weekly injection of 300 mg. AD severity, as measured by investigator global assessment, was documented at the start of treatment and at the onset of conjunctivitis.

    At baseline, 9 (75%) of the 12 pa­tients had severe AD. The mean age at conjunctivitis onset was 30 years. The conjunctivitis occurred at a mean of 15.8 weeks of treatment (range, 8-41 weeks) and was considered severe or moderate-to-severe in 4 patients. Dup­ilumab was stopped in 3 patients, all of whom had severe conjunctivitis. These 3 patients had severe AD at baseline plus at least 1 other atopic condition. The 2 patients who discontinued the drug permanently also had a history of hay fever. In both of these patients, the conjunctivitis improved after treatment and dupilumab discontinuation, but it did not resolve fully.

    Larger, multicenter studies are needed to confirm risk factors and determine effective treatment for con­junctivitis. At-risk patients may benefit from early ophthalmology referral and prophylactic care.

    The original article can be found here.