Ocular complications induced during dupilumab treatment of atopic dermatitis

Atopic dermatitis (AD), is a common, chronic inflammatory pruritic dermatosis. It affects children as well as adults. Its etiology is multifactorial and involves complex interactions between genetic predisposition, dysregulation of the immune system, alteration of the skin barrier and the environment. Interleukins (IL)4 and IL-13 play a key role. Dupilumab is the first biomolecule approved for the treatment of moderate to severe AD. It is a monoclonal antibody directed against the common chain of IL-4 and IL-13receptors. Dupilumab has been shown to be very effective in both the first phase II and III clinical trials and in real life setting. It is overall well tolerated, however a high frequency of adverse eye events, such as conjunctivitis and dry eye syndromes, has been noted. Their management is usually easy but in some cases their severity requires treatment interruption. Understanding the involved molecular mechanisms is important in identifying patients at risk and adapting their treatment in close collaboration between the dermatologist and ophthalmologist. (C) 2021 Elsevier Masson SAS. All rights reserved.

Automated summary

Atopic dermatitis is a common chronic inflammatory skin disease with multifactorial etiology. Dupilumab, the first approved biomolecule for moderate to severe AD, has shown effectiveness but may cause adverse eye events that require careful management. Understanding molecular mechanisms is key for identifying at-risk patients and optimizing treatment in collaboration between dermatologists and ophthalmologists.