MANAGEMENT OF OCULAR SURFACE INFLAMMATION INDUCED BY DUPILUMAB
Published 2024 - 28th ESCRS Winter Meeting
Reference: P154 | Type: Presented Poster & Poster | DOI: 10.82333/zgft-3e47
Authors: Víctor Lázaro-Rodríguez* 1 , David Aragón-Roca 2 , Noelia Sabater 1 , Miguel Ángel Gil 1 , Zoraida del Campo 1
1Hospital de Sant Pau,Barcelona,Spain, 2Hospital del Mar,Barcelona,Spain
Purpose
Dupilumab is an interleukin IL-4 and IL-13 monoclonal antibody inhibitor. It is used as a treatment for moderate-severe atopic dermatitis. As a side effect, follicular conjunctivitis stands out, especially in patients with atopic dermatitis. The purpose is to present a case of ocular surface inflammation caused by Dupilumab and its management.
Setting
Hospital de la Santa Creu i Sant Pau, Barcelona (Spain).
Methods
A 35-year-old male patient with atopic dermatitis being treated with dupilumab by Dermatology department was referred to Ophthalmology department due to red, itchy, and watery eyes despite the instillation of artificial tears. Ophthalmological examination revealed eyelid eczema, anterior and posterior blepharitis, tarsal follicular reaction, conjunctival hyperemia predominantly limbar, and superficial punctate keratitis in both eyes.
Results
Treatment was prescribed with topical dexamethasone in a descending regimen along with eyelid hygiene measures and artificial tears without preservatives, showing a substantial improvement. The patient presented recurrences after successive treatments with dupilumab that were satisfactorily managed with topical 0.1% fluorometholone in a descending regimen, topical 0.1% cyclosporine, eyelid hygiene and artificial tears without preservatives, without the need to suspend treatment with dupilumab, with a 6-year follow-up.
Conclusion
After the approval of dupilumab by the European Medicines Agency, conjunctivitis associated with this drug is increasingly common in Ophthalmology departments. The multidisciplinary management of these patients is essential, recommending an ophthalmological examination prior to starting the drug and follow-up for the active identification of possible ocular adverse effects. The purpose of this work is to present a clinical case of dupilumab associated conjunctivitis to analyse the physiopathogenic mechanism, present the experience accumulated in our centre, as well as review the current therapy for adequate management.