Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis

Thyssen, Jacob P.; Toft, Peter Bjerre; Halling, Anne‐Sofie; Gislason, Gunnar; Skov, Lone; Egeberg, Alexander

doi:10.1016/j.jaad.2017.03.003

Cited by 122 publications

(145 citation statements)

References 24 publications

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“…Irrespective of the treatment they receive, approximately 20–43 % of patients with atopic dermatitis develop ocular symptoms . Conjunctivitis, keratitis and blepharitis in particular are common in these patients – the more severe the atopic dermatitis, the more frequently does ocular involvement occur . A meta‐analysis of adverse drug reactions to dupilumab in the treatment of atopic dermatitis (2,495 patients in four studies: phase 2b dose finding, SOLO1, SOLO2, CHRONOS) shows that conjunctivitis occurred in 8 % of patients treated with dupilumab (Table ) and in only 3.6 % of patients on placebo .…”

Section: Clinical Presentationmentioning

confidence: 99%

Management of dupilumab‐associated conjunctivitis in atopic dermatitis

Aszodi¹,

Thurau²,

Seegräber³

et al. 2019

J Deutsche Derma Gesell

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Summary Since September 2017, the monoclonal antibody dupilumab (Dupixent®) has been approved in the EU for the treatment of moderate‐to‐severe atopic dermatitis. By blocking IL‐4 and IL‐13 signaling pathways, dupilumab improves both objective signs and subjective symptoms of the disease. Blocking of the IL‐4aRα subunit leads to improvement of the skin's barrier function and reduction in Th2‐mediated inflammation. While the rate of adverse events on dupilumab is generally low, mild‐to‐moderate conjunctivitis associated with redness as well as a burning and foreign body sensation has been reported in up to 28 % of patients. Treatment options include topical corticosteroids and topical calcineurin inhibitors. The present review highlights the clinical presentation of dupilumab‐associated conjunctivitis and addresses pharmacological and non‐pharmacological options available for the treatment of this clinically highly relevant condition.

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Section: Clinical Presentationmentioning

confidence: 99%

Management of dupilumab‐associated conjunctivitis in atopic dermatitis

Aszodi¹,

Thurau²,

Seegräber³

et al. 2019

J Deutsche Derma Gesell

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“…Patients with AD have greater risk of conjunctivitis than the general population, and patients with more severe AD have greater risk than those with mild disease . Interestingly, no imbalances in conjunctivitis AEs were observed between the dupilumab and placebo arms in studies of other allergic/atopic disorders (asthma, chronic sinusitis with nasal polyposis, eosinophilic esophagitis), suggesting that both dupilumab‐ and AD‐related mechanisms may be involved.…”

mentioning

confidence: 99%

Could conjunctivitis in patients with atopic dermatitis treated with dupilumab be caused by colonization with Demodex and increased interleukin-17 levels?: reply from the authors

et al. 2018

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“…Dupilumab may increase OX40 ligand activity, which is involved in atopic keratoconjunctivitis . An increase in eosinophil counts after dupilumab administration might be another mechanism, as eosinophilic factors are elevated in the tears of patients with allergic conjunctivitis . IL‐13 inhibition might be another possible mechanism because it has been implicated in ocular mucus production and the regulation of conjunctival goblet cells and, therefore, the quality of tears .…”

mentioning

confidence: 99%

“…1,2,6 An increase in eosinophil counts after dupilumab administration might be another mechanism, as eosinophilic factors are elevated in the tears of patients with allergic conjunctivitis. 5,7 IL-13 inhibition might be another possible mechanism because it has been implicated in ocular mucus production and the regulation of conjunctival goblet cells and, therefore, the quality of tears. 5,8 In a phase II trial of lebrikizumab, a monoclonal antibody against IL-13, a trend for increased conjunctivitis was also noticed.…”

mentioning

confidence: 99%