Lin Tzu-Yi, Wang Ching-Ya, Wang Fang-Ying, Kang Eugene Yu-Chuan, Hwang Yih-Shiou
Department of Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan.
School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Pharmaceutics. 2023 Mar 23;15(4):1031. doi: 10.3390/pharmaceutics15041031.
Conjunctivitis is commonly reported in dupilumab users with atopic dermatitis (AD), and few studies have compared the risk of conjunctivitis among patients with different indications. This study aimed to investigate the association between dupilumab and conjunctivitis in various diseases. The protocol of this study was registered on PROSPERO (ID CRD42023396204). The electronic search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov was conducted for the period from their inception to January 2023. Only placebo-controlled, randomized controlled trials (RCTs) were included. The main outcome was the incidence of conjunctivitis during the study period. The subgroup analysis was performed for patients with AD and non-AD indications, which include asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis. In total, 23 RCTs involving 9153 patients were included for meta-analysis. Dupilumab users exhibited significantly higher risk of conjunctivitis (risk ratio [RR], 1.89; 95% confidence interval [CI], 1.34-2.67) than placebo users. Notably, significantly increased incidence of conjunctivitis was observed in the dupilumab group relative to the placebo group among patients with AD (RR, 2.43; 95% CI, 1.84-3.12) but not among patients with non-AD indications (RR, 0.71; 95% CI, 0.43-1.13). In conclusion, only dupilumab users with AD but not those with non-AD indications reported an elevated incidence of conjunctivitis.
在使用度普利尤单抗治疗特应性皮炎（AD）的患者中，结膜炎较为常见，而很少有研究比较不同适应症患者患结膜炎的风险。本研究旨在调查度普利尤单抗与各种疾病中结膜炎之间的关联。本研究方案已在国际前瞻性注册平台（PROSPERO）上注册（ID：CRD42023396204）。对PubMed、Embase、Cochrane图书馆和ClinicalTrials.gov进行了从创建至2023年1月的电子检索。仅纳入安慰剂对照的随机对照试验（RCT）。主要结局是研究期间结膜炎的发病率。对患有AD和非AD适应症（包括哮喘、伴有鼻息肉的慢性鼻-鼻窦炎和嗜酸性食管炎）的患者进行亚组分析。总共纳入了23项涉及9153名患者的RCT进行荟萃分析。与安慰剂使用者相比，度普利尤单抗使用者患结膜炎的风险显著更高（风险比[RR]，1.89；95%置信区间[CI]，1.34 - 2.67）。值得注意的是，在患有AD的患者中，度普利尤单抗组的结膜炎发病率相对于安慰剂组显著增加（RR，2.43；95% CI，1.84 - 3.12），但在患有非AD适应症的患者中并非如此（RR，0.71；95% CI，0.43 - 1.13）。总之，只有患有AD的度普利尤单抗使用者报告结膜炎发病率升高，而非AD适应症患者则不然。
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