Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2019 Jul;33(7):1224-1231. doi: 10.1111/jdv.15608. Epub 2019 May 6.
Conjunctivitis is common in patients with atopic dermatitis (AD) in general and a commonly reported adverse event in AD clinical trials with dupilumab.
To survey opinions and experience about conjunctivitis occurring in AD, including those during dupilumab treatment in a group of AD experts from the International Eczema Council (IEC).
Electronic survey and in-person discussion of management strategies.
Forty-six (53.5%) IEC members from 19 countries responded to the survey. Consensus was reached for several statements regarding diagnostic workup, referral and treatment. IEC members suggest that patients with AD should (i) routinely be asked about ocular complaints or symptoms, (ii) obtain information about the potential for conjunctivitis before starting dupilumab therapy and (iii) if indicated, be treated with dupilumab despite previous or current conjunctivitis. In cases of new-onset conjunctivitis, there was consensus that dupilumab treatment should be continued when possible, with appropriate referral to an ophthalmologist.
The study relies on expert opinion from dermatologists. Responses from few dermatologists without dupilumab access were not excluded from the survey.
The IEC recommends that dermatologists address conjunctivitis in patients with AD, especially during treatment with dupilumab.
结膜炎在特应性皮炎(AD)患者中很常见,也是阿达木单抗治疗 AD 临床试验中常见的不良事件。
调查一组来自国际特应性皮炎理事会(IEC)的 AD 专家对 AD 中发生的结膜炎(包括在阿达木单抗治疗期间发生的结膜炎)的意见和经验。
电子调查和现场讨论管理策略。
来自 19 个国家的 46 名(53.5%)IEC 成员对该调查做出了回应。针对诊断性检查、转诊和治疗,IEC 成员就几个声明达成了共识。IEC 成员建议,AD 患者应(i)常规询问眼部不适或症状,(ii)在开始阿达木单抗治疗前获取有关结膜炎潜在风险的信息,(iii)如果需要,尽管有既往或目前的结膜炎,也应使用阿达木单抗进行治疗。对于新发结膜炎,共识认为在可能的情况下应继续使用阿达木单抗治疗,并适当转诊至眼科医生。
该研究依赖于皮肤科医生的专家意见。该调查并未排除来自无法获得阿达木单抗的皮肤科医生的少数回复。
IEC 建议皮肤科医生治疗 AD 患者的结膜炎,尤其是在使用阿达木单抗治疗期间。