The Value of Patient-Reported Questionnaires in Detecting Ocular Surface Manifestations in Dupilumab Therapy: A...

Area of Science:

• Ophthalmology
• Dermatology
• Pharmacology

Background:

• Dupilumab-associated ocular surface disease (DAOSD) presents with varied manifestations and unclear risk factors.
• Objective assessments and patient-reported outcomes are crucial for evaluating ocular surface disease (OSD) in patients treated with Dupilumab.

Purpose of the Study:

• To evaluate ocular surface disease (OSD) in Dupilumab-treated patients using objective assessments and a patient-reported questionnaire.
• To identify risk factors and manifestations associated with DAOSD.

Main Methods:

• A case-control study included 58 Dupilumab-treated adults, categorized by the DAOSD Questionnaire into cases (≥3 symptoms or ≥1 severe symptom) and controls (<3 symptoms without daily impact).
• Objective ocular surface parameters assessed included eye redness, non-invasive tear break-up time (NIBUT), tear meniscus thickness, tear film stability evaluation (TFSE®), and tear osmolarity.
• The Ocular Surface Disease Index (OSDI) was used to classify symptom severity.

Main Results:

• Patients with DAOSD (cases) exhibited significantly higher tear osmolarity and eye redness compared to controls.
• While TFSE values trended higher and NIBUT trended lower in cases, conjunctivitis and posterior blepharitis were more frequent.
• OSDI scores were significantly higher in the DAOSD group, with 37.5% classified as having severe disease.

Conclusions:

• DAOSD is associated with an increased symptom burden and objective ocular surface changes.
• The DAOSD questionnaire demonstrates correlation with OSDI scores and ocular surface parameters, supporting its utility in early detection.
• Findings support the use of the DAOSD questionnaire for timely referral and ophthalmological management of patients experiencing ocular side effects from Dupilumab therapy.