Tauqeer Zujaja, Jinno Stephanie E, Chung Caroline W, Massaro-Giordano Mina, Bunya Vatinee Y
Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Drexel University School of Medicine, Philadelphia, PA, USA.
Clin Ophthalmol. 2022 Mar 29;16:947-958. doi: 10.2147/OPTH.S336978. eCollection 2022.
Ocular adverse events have been reported in association with dupilumab, a monoclonal antibody to treat allergic diseases including atopic dermatitis (AD). We describe clinical findings and treatment of dupilumab-related ocular complications.
Retrospective study of 19 dupilumab-treated AD patients seen for a new ocular complaint. Primary outcomes were specific ocular exam findings (conjunctival injection, corneal fluorescein staining, blepharitis, meibomian gland dysfunction (MGD)), treatments, and follow-up.
Nineteen dupilumab-treated AD patients were included. Median age was 47 years (range 18-73). Over half were women (11/19) and majority were Caucasian (13/19). Symptom onset occurred at a mean of 99 days (range 23-520 days) from first dupilumab dose. The most common symptoms were redness (63%), tearing (47%), and pruritus (37%). Most common ocular findings were conjunctival injection (75%) and corneal staining (60%). Blepharitis was seen in about a third (30%), and 25% had MGD. Initially, 10% were observed without treatment, while 15% were treated with artificial tears alone. Other treatments included antihistamine drops (20%) and steroid drops alone (15%). In 40% of patients, a combination of steroids and various other topical eye drops were prescribed. Eighty-four percent (16/19) of patients were seen for follow-up. Steroid drops were required at follow-up in 3 out of 4 patients initially treated with antihistamines alone and in two-thirds of patients initially treated with artificial tears only. Mean follow-up period was 88 days (range 5-369). Dupilumab was discontinued in 31.5% (6/19) of patients; of those who discontinued, 3 restarted it later.
Conjunctival injection was the most frequent dupilumab-related ocular symptom and most common exam finding followed by corneal staining. Most patients initially treated with antihistamine drops or artificial tears alone subsequently required steroid drops to control symptoms. Some patients who discontinued dupilumab restarted the medication after achieving adequate control of ocular symptoms.
已报告与度普利尤单抗相关的眼部不良事件，度普利尤单抗是一种用于治疗包括特应性皮炎（AD）在内的过敏性疾病的单克隆抗体。我们描述了度普利尤单抗相关眼部并发症的临床发现及治疗情况。
对19例因新发眼部不适而接受度普利尤单抗治疗的AD患者进行回顾性研究。主要结局指标为特定的眼部检查结果（结膜充血、角膜荧光素染色、睑缘炎、睑板腺功能障碍（MGD））、治疗方法及随访情况。
纳入19例接受度普利尤单抗治疗的AD患者。中位年龄为47岁（范围18 - 73岁）。超过半数为女性（11/19），大多数为白种人（13/19）。症状出现的时间距首次使用度普利尤单抗剂量的平均时间为99天（范围23 - 520天）。最常见的症状为眼红（63%）、流泪（47%）和瘙痒（37%）。最常见的眼部检查发现为结膜充血（75%）和角膜染色（60%）。约三分之一（30%）的患者出现睑缘炎，25%的患者有MGD。最初，10%的患者未接受治疗而仅进行观察，15%的患者仅使用人工泪液治疗。其他治疗包括抗组胺滴眼液（20%）和单独使用类固醇滴眼液（15%）。40%的患者同时使用了类固醇和其他各种局部滴眼液。84%（16/19）的患者接受了随访。最初仅接受抗组胺滴眼液治疗的患者中，4例中有3例在随访时需要使用类固醇滴眼液，最初仅使用人工泪液治疗的患者中有三分之二在随访时需要使用类固醇滴眼液。平均随访期为88天（范围5 - 369天）。31.5%（6/19）的患者停用了度普利尤单抗；在那些停用的患者中，3例后来重新开始使用。
结膜充血是与度普利尤单抗相关最常见的眼部症状，也是最常见的检查发现，其次是角膜染色。大多数最初仅接受抗组胺滴眼液或人工泪液治疗的患者随后需要使用类固醇滴眼液来控制症状。一些停用度普利尤单抗的患者在眼部症状得到充分控制后重新开始使用该药物。
