Eye Complications During Dupilumab Treatment for Severe Atopic Dermatitis

Acta Derm Venereol. 2019 Apr 1;99(4):375-378. doi: 10.2340/00015555-3121.

Abstract

Dupilumab, the first biologic approved for treatment of atopic dermatitis, has demonstrated significant clinical effect and quality of life-enhancing capacity in clinical trials. In these, dupilumab-associated conjunctivitis where reported in a minority of patients. The present case series describe 10 patients treated with dupilumab where eye complications were very common. We have described patient characteristics, including FLG mutations, atopic history and clinical effect of dupilumab. Nine of 10 developed eye-complications, most commonly conjunctivitis (in 7/10). Other adverse events were herpes simplex virus uveitis and varicella-zoster virus meningitis. Although our case series is small, we conclude that dupilumab is an effective treatment option in severe atopic dermatitis, but that the risk of adverse events from the eyes and recurrence of herpes virus infections should be kept in mind. Close collaboration with an ophthalmologist is recommended, especially among patients with severe, long-lasting atopic dermatitis and/or previous eye disease.

Keywords: atopic dermatitis; dupilumab; efficacy; ocular adverse events; safety.

MeSH terms

  • Adult
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Biological Products / adverse effects*
  • Conjunctivitis / chemically induced*
  • Conjunctivitis / diagnosis
  • Conjunctivitis / immunology
  • Dermatitis, Atopic / diagnosis
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / immunology
  • Eye Infections, Viral / chemically induced
  • Eye Infections, Viral / immunology
  • Female
  • Filaggrin Proteins
  • Herpes Simplex / chemically induced
  • Herpes Simplex / immunology
  • Herpes Simplex / virology
  • Herpes Zoster / chemically induced
  • Herpes Zoster / immunology
  • Herpes Zoster / virology
  • Humans
  • Immunocompromised Host
  • Male
  • Meningitis, Viral / chemically induced
  • Meningitis, Viral / immunology
  • Meningitis, Viral / virology
  • Middle Aged
  • Opportunistic Infections / chemically induced
  • Opportunistic Infections / immunology
  • Opportunistic Infections / virology
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Uveitis, Anterior / chemically induced
  • Uveitis, Anterior / immunology
  • Uveitis, Anterior / virology
  • Young Adult

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • FLG protein, human
  • Filaggrin Proteins
  • dupilumab