Conjunctivitis in patients with atopic dermatitis treated with dupilumab

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Abstract

Atopic dermatitis (AD) is a common, chronic, inflammatory skin disorder with high physical and emotional burden. Robust evidence suggests that interleukin (IL)-4 and IL- 13 are key cytokines in the immunopathogenesis of AD. New emerging agents include dupilumab, a fully human monoclonal antibody directed against the IL-4 receptor a subunit that blocks both IL-4 and IL-13 signaling and has shown significant efficacy in patients with moderate-tosevere AD. Dupilumab is approved for the treatment of moderate-to-severe AD, moderate-to-severe eosinophilic or oral corticosteroid-dependent asthma, and chronic rhinosinusitis with nasal polyps. Data from phase phase 2 and 3 studies have revealed that dupilumab generally has a low rate of adverse events, although an increased incidence of mild-to-moderate conjunctivitis has been reported for dupilumab compared with placebo. The present paper reviews the data of dupilumab-associated conjunctivitis and risk factors in adults with moderate-to-severe AD and other atopic diseases in dupilumab clinical trials and addresses the characteristics and treatment options available for this clinically highly relevant condition. Additionally, it presents data from ten studies in the real-life setting with dupilumab. Dupilumab-associated conjunctivitis incidence is higher in AD, although most cases are mild-to-moderate and have good response to topical treatment, with no need to suspend dupilumab therapy.

Keywords: atopic dermatitis, atopic eczema, conjunctivitis, dupilumab.

Citation: Ferreira F, Torres T. Conjunctivitis in patients with atopic dermatitis treated with dupilumab. Drugs in Context 2020; 9: 2020-2-3. DOI: 10.7573/dic.2020-2-3

Contributions: All authors collaborated in the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Sandra Ferreira has no conflicts of interest. Tiago Torres declares receiving personal fees from AbbVie, Arena Pharmaceuticals, Celgene, Janssen-Cilag, Leo-Pharma, Eli-Lilly, Pfizer and Sanofi-Genzyme. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/04/dic.2020-2-3-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2020 Ferreira F, Torres T. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Ferreira F, Torres T. https://doi.org/10.7573/dic.2020-2-3. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://drugsincontext.com/conjunctivitis-in-patients-with-atopic-dermatitis-treated-with-dupilumab

Correspondence: Tiago Torres, Serviço de Dermatologia, Piso 1, CHUP (Edifício 2 CICAP), Rua Dom Manuel II s/n, 4050-344 Porto, Portugal. torres.tiago@outlook.com

Provenance: invited; externally peer reviewed.

Submitted: 21 February 2020; Peer review comments to author: 18 March 2020; Revised manuscript received: 3 April 2020; Accepted: 8 April 2020; Publication date: 4 May 2020.

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