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J Eur Acad Dermatol Venereol. 2019 May 6. doi: 10.1111/jdv.15608. [Epub ahead of print]

Conjunctivitis in atopic dermatitis patients with and without dupilumab therapy - international eczema council survey and opinion.

Author information

1
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark.
2
Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
3
National Expertise Center of Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
4
Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
5
Department of Dermatology, Beilinson Hospital, Petah Tikva, Israel.
6
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
7
Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark.
8
Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
9
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
10
Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
11
Department of Dermatology, Venereology and Allergy, University Clinics of Schleswig-Holstein, Kiel, Germany.
12
Institute of Environmental Medicine, UNIKA-T, Technical University of Munich, Augsburg, Germany.
13
Research Center for Environmental Health, Helmholtz Zentrum München, Augsburg, Germany.
14
Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
15
Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
16
Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
17
Department of Dermatology, Eastern Health, Monash University, Parkville, Vic, Australia.
18
Department of Pediatrics, MCRI, University of Melbourne, Parkville, Vic, Australia.
19
Department of Dermatology and Allergy, University of Bonn, Bonn, Germany.
20
Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK.
21
Department of Dermatology, San Diego School of Medicine, University of California, San Diego, CA, USA.
22
Department of Pediatrics, San Diego School of Medicine, University of California, San Diego, CA, USA.
23
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
24
Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.
25
Klinikum Thalkirchner Straße, München, Germany.

Abstract

BACKGROUND:

Conjunctivitis is common in patients with atopic dermatitis (AD) in general and a commonly reported adverse event in AD clinical trials with dupilumab.

OBJECTIVE:

To survey opinions and experience about conjunctivitis occurring in AD, including those during dupilumab treatment in a group of AD experts from the International Eczema Council (IEC).

METHODS:

Electronic survey and in-person discussion of management strategies.

RESULTS:

Forty-six (53.5%) IEC members from 19 countries responded to the survey. Consensus was reached for several statements regarding diagnostic workup, referral and treatment. IEC members suggest that patients with AD should (i) routinely be asked about ocular complaints or symptoms, (ii) obtain information about the potential for conjunctivitis before starting dupilumab therapy and (iii) if indicated, be treated with dupilumab despite previous or current conjunctivitis. In cases of new-onset conjunctivitis, there was consensus that dupilumab treatment should be continued when possible, with appropriate referral to an ophthalmologist.

LIMITATIONS:

The study relies on expert opinion from dermatologists. Responses from few dermatologists without dupilumab access were not excluded from the survey.

CONCLUSION:

The IEC recommends that dermatologists address conjunctivitis in patients with AD, especially during treatment with dupilumab.

PMID:
31056788
DOI:
10.1111/jdv.15608
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