Clinical Characteristics, Treatment, and Follow-Up of Dupilu
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A consecutive case series of patients with dupilumab-associated ocular surface disease (DAOSD) that describes common ocular symptoms and signs, proposes a symptom disease severity grading system, and describes treatment strategies of DAOSD patients was evaluated.

A retrospective chart review of patients with concomitant dupilumab-treated atopic dermatitis and DAOSD with ophthalmic evaluation was conducted.

--29 patients (mean age 46 years, M/F: 12/17) with 57 ophthalmic exams were identified. The most common ocular symptoms included irritation/pain (n = 28), redness (n = 24), pruritus (n = 18), discharge (n = 18), and light sensitivity (n = 6).

--The most frequent signs included conjunctival injection (n = 18), superficial punctate keratitis (n = 16), and papillary reaction (n = 8).

--Topical corticosteroids (TCS) (n = 23), tacrolimus (n = 6), and artificial tears (n = 7) were the most commonly used therapies.

--Of those with follow-up documentation (n = 21), 20 were noted to have partial or complete response with TCS based on symptoms and reduction of signs.

Using this proposed symptom-based grading scale, scaled 1 to 5 based on the presence of common symptoms listed above, 66% requiring topical immunomodulating therapy were found in the ‘severe’ group (more than 3 symptoms) and 17% were found in the ‘mild’ group (less than 2 symptoms).

To summarize, this research sheds light on the most common ocular signs and symptoms associated with DAOSD, as well as the efficacy of TCS and other immunomodulators in alleviating DAOSD symptoms. Based on these results, a symptom-based grading system was suggested to assist non-ophthalmic physicians with ophthalmology consultations.