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Dupilumab-associated cicatrizing ocular disease
Amit K Reddy1, Scott G Hauswirth1, Darren G Gregory1
1Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
American Journal of Ophthalmology Case Reports
|April 28, 2022
Summary
Dupilumab treatment for atopic dermatitis may cause cicatrizing conjunctivitis. Discontinuing or reducing the dupilumab dose can stabilize this ocular side effect, even in cases with symblepharon.
Area of Science:
- Ophthalmology
- Dermatology
- Pharmacology
Background:
- Atopic dermatitis is a chronic inflammatory skin condition.
- Dupilumab is a biologic therapy targeting interleukin-4 and interleukin-13 signaling pathways, commonly used for atopic dermatitis.
- Cicatrizing conjunctivitis is a severe form of eye inflammation leading to scarring.
Observation:
- Three male patients with atopic dermatitis developed cicatrizing conjunctivitis during dupilumab treatment.
- Symptoms included ocular erythema, irritation, and symblepharon formation.
- Ocular disease progression was observed after initiating dupilumab.
Findings:
- Dupilumab discontinuation led to stabilization of cicatrizing conjunctivitis in two patients.
- In one case, a reduced dose of dupilumab stabilized ocular symptoms while improving atopic dermatitis.
- The observed conjunctivitis appears distinct from ocular cicatricial pemphigoid.
Implications:
- Cicatrizing conjunctivitis is a potential adverse effect of dupilumab therapy for atopic dermatitis.
- Management may involve discontinuing or reducing the dupilumab dosage.
- Further research is needed to understand the mechanism and long-term implications of this side effect.
