Ocular side effects of dupilumab-Review article and treatment recommendation by the Committee for Dry Eye and Ocular Surface Diseases of the Austrian Society of Ophthalmology (?OG)

Dupilumab (Dupixent (R), Sanofi and Regeneron Pharmaceuticals) is a human monoclonal antibody against the interleukin (IL)-4 receptor alpha subunit of IL-4 and IL-13 and is approved for the treatment of atopic dermatitis in patients over 6 months old. In real-world studies it could be shown that side effects in the sense of ocular surface diseases occurred in up to 62% of patients with atopic dermatitis treated with dupilumab. In most cases these were mildly to moderately expressed and presented as (blepharo)conjunctivitis or superficial keratitis, which could mostly be sufficiently treated by local ophthalmological therapy without reduction or discontinuation of dupilumab; however, there were also isolated cases of severe ocular side effects, such as scarring of the ocular surface or eyelids as well as corneal ulcers and corneal perforation. This article provides important background information on the ocular side effects of dupilumab and presents a practice relevant treatment recommendation for ophthalmologists.