Treister AD, et al. - In this case series, researchers depicted the traits of patients who develop conjunctivitis secondary to dupilumab treatment for atopic dermatitis (AD). It may be necessary to stop therapy in some severe cases of conjunctivitis that develops following the administration of dupilumab. In patients with more severe baseline AD with a good response to dupilumab and an increased atopic phenotype, severe conjunctivitis was more likely to develop.

Methods

• Out of a cohort of 142 patients treated with dupilumab for AD at a secondary care center from March 14, 2017, to March 29, 2018, this case series included 12 subjects who reported development of conjunctivitis.
• Patients received a 600-mg injection of dupilumab as a loading dose and a subsequent 300-mg injection every 2 weeks for this analysis.
• Severity of AD as measured by the Investigator Global Assessment (IGA) score, a 5-point scale from 0 (clear) to 4 (severe), at the time of dupilumab initiation and at conjunctivitis onset were primary outcome measures.

Results

• It was observed that the mean (SD) age of patients was 30 (8.1) years at the time conjunctivitis developed; 7 patients (58%) were male.
• All patients displayed improvement of their AD at the time of conjunctivitis diagnosis, with a mean (SD) 1.9 (0.8)–point decrease in IGA score and 47.8% (11.2%) decrease in body surface area affected.
• It was noted that 9 of the 12 patients (75%) had severe baseline AD with an IGA score of 4.
• Severe AD at the time of initial dupilumab administration and at least one atopic condition in addition to AD was seen in all patients who discontinued treatment.