Use of artificial tears may prevent the occurrence of ocular surface disease (OSD) in patients with severe atopic dermatitis (AD) undergoing treatment with dupilumab, according to findings published in the Journal of the European Academy of Dermatology and Venerology.

Clinical trials have shown that the use of dupilumab increases the incidence of ocular surface disease (OSD), which includes dry eye, keratitis, and conjunctivitis, but it remains unclear why OSD occurs exclusively in patients with AD.

The researchers noted the hypothesis that dupilumab may have a different molecular mechanism in AD, or OSD resulting from treatment with dupilumab may be due to properties specific to the eye. Therefore, they investigated the use of artificial tears in the prevention of ocular complications in 30 adult patients with severe AD receiving treatment with dupilumab. Treatment with dupilumab was initiated at a dose of 600 mg, with 300 mg injected every other week; during the first administration patients were instructed to use artificial tears, 1 drop per eye twice a day.

After 6 months of treatment with dupilumab and the use of artificial tears, none of the patients reported ocular symptoms or the appearance of conjunctivitis and keratitis.

Study limitations include its small number of patients.

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The researchers suggest that future studies include collaboration with ophthalmology specialists to create an ad hoc protocol designed to improve the quality of life of patients with AD treated with dupilumab who experience OSD.

Reference

Pistone G, Tilotta G, Gurreri R, Castelli E, Curiale S, Bongiorno MR. Ocular surface disease during dupliumab treatment in patients with atopic dermatitis, is it possible to prevent it? [published online January 27, 2020].  J Eur Acad Dermatol Venereol. doi:org/10.1111/JDV.16234