Multicenter prospective observational study of dupilumab‐induced ocular events in atopic dermatitis patients
I. Costedoat, Martin Wallaert, Aurélie Gaultier, Robin Vasseur, C. Vanhaecke, M. Viguier, Charles Cordelette, Alexandre Denoyer, Marie‐Christine Ferrier le Bouëdec, A. Coutu, Marie Lamiaux, Thi Hà Châu Tran, J.‐P. Lacour, Valerie Elmaleh, F. Tétart, J. Gueudry, M. Tauber, F. Giordano‐Labadie, Myriam Cassagne, Audrey Nosbaum, Coralie Ouilhon, M. Jachiet, Ramin Tadayoni, F. Dezoteux, D. Staumont‐Sallé, Julien Bouleau, P. Labalette, Serge Doan, A. Soria, B. Mortemousque, Julien Sénéschal, S. Barbarot, FRench Atopic DErmatitis Network from the Groupe de Recherche sur l'Eczema Atopique (GREAT), France
Abstract
BACKGROUND: 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. OBJECTIVE: To examine the incidence, characteristics and risk factors of dupilumab-induced ocular adverse events. METHODS: A prospective, multicenter, and real-life study in adult AD patients treated with dupilumab. RESULTS: 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. LIMITATIONS: Our follow-up period was 16 weeks and some late-onset time effects may still occur. CONCLUSION: 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.