A rare case of vernal keratoconjunctivitis in a patient with atopic dermatitis treated with tralokinumab

Lai, Belinda; Phan, Kim M.; Lewis, Noni; Shumack, Stephen

doi:10.1111/jdv.17824

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Consequently, there is a strong association between VKC and AD, with VKC often occurring concurrently with AD [ 7 , 8 ]. Treatments such as cyclosporine, dupilumab, and tralokinumab inhibit Th2 cytokine signals, including IL-4 and IL-13; thus, these treatments have been approved for severe AD [ 18 , 19 , 20 , 22 , 25 ]. Moreover, they have been reported to effectively control VKC [ 18 , 19 , 20 , 22 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatments such as cyclosporine, dupilumab, and tralokinumab inhibit Th2 cytokine signals, including IL-4 and IL-13; thus, these treatments have been approved for severe AD [ 18 , 19 , 20 , 22 , 25 ]. Moreover, they have been reported to effectively control VKC [ 18 , 19 , 20 , 22 , 25 ]. However, no reports have discussed whether upadacitinib is effective for VKC treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it has been suggested that dupilumab inhibits IL-4 and IL-13 cytokine signaling, resolves giant papillae, and reduces inflammatory mediator overproduction, contributing to the control of refractory VKC [ 22 ]. Additionally, it has been documented that tralokinumab, by inhibiting the IL-13 cytokine signal, successfully controlled resistant VKC [ 25 ]. Here, we report a case of refractory VKC accompanied by AD that rapidly improved after upadacitinib administration.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Refractory Vernal Keratoconjunctivitis Showing Improvement after the Administration of Upadacitinib for the Treatment of Atopic Dermatitis

Mima,

Tsutsumi,

Ohtsuka

et al. 2024

Diagnostics

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Vernal keratoconjunctivitis is a persistent allergic ocular disease predominantly mediated by the T-helper 2 lymphocyte-associated immune response. The standard therapeutic approaches for vernal keratoconjunctivitis include topical corticosteroids and immunosuppressive eye drops. However, managing vernal keratoconjunctivitis with only topical treatments becomes challenging during seasonally exacerbated periods. Systemic treatments such as oral corticosteroids or cyclosporine may be alternative options. Recently, dupilumab’s efficacy in refractory vernal keratoconjunctivitis treatment has been documented. Here, we report a case of refractory vernal keratoconjunctivitis coexisting with atopic dermatitis that rapidly improved after upadacitinib administration. An 18-year-old Japanese woman presented with atopic dermatitis, vernal keratoconjunctivitis, and hay fever. In winter, the patient experienced widespread erythema and escalated itching, leading to significant discomfort and insomnia. Owing to the difficulty in maintaining her current regimen, upadacitinib (15 mg), a Janus kinase inhibitor was initiated. After upadacitinib administration, the treatment-resistant vernal keratoconjunctivitis and erythema improved. Upadacitinib is beneficial in severe cases of atopic dermatitis. Consequently, in our case, upadacitinib may offer therapeutic benefits for refractory vernal conjunctivitis by improving the T-helper 1/2 type immune response, autoimmunity, and oxidative stress. To our knowledge, this is the first report suggesting the potential utility of upadacitinib in managing severe vernal conjunctivitis.

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