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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Inflammation Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1425550

A risk-scoring system to predict dupilumab-associated ocular surface disease in patients with atopic dermatitis

Provisionally accepted
Sunyoung Shim Sunyoung Shim 1,2Jung Sun Kim Jung Sun Kim 1Jeong Yee Jeong Yee 3Hye Sun Gwak Hye Sun Gwak 1*
  • 1 Ewha Womans University, Seoul, Republic of Korea
  • 2 Yeouido St. Mary’s Hospital, Catholic University of Korea, Soeul, Seoul, Republic of Korea
  • 3 School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi, Republic of Korea

The final, formatted version of the article will be published soon.

    Introduction: Dupilumab is the first biological treatment for atopic dermatitis (AD).Dupilumab-associated ocular surface disease (DAOSD) is one of the most commonly reported side effects in patients with AD during dupilumab treatment. This study aimed to identify risk factors for DAOSD in a real-world setting and construct a risk-scoring system for predicting DAOSD risk.Methods: A retrospective analysis was conducted for dupilumab-treated adult patients with AD between April 2019 and September 2023 at Yeouido St. Mary's Hospital in Korea. Patients aged ≥ 18 years who received dupilumab to treat AD were included. Univariate and multivariable logistic regression analyses were performed to determine independent risk factors for DAOSD. A risk scoring system was constructed to predict DAOSD risk based on the adjusted odd ratios of significant variables.Of the 97 dupilumab-treated patients, 28 (28.9%) developed DAOSD. Among them, three (10.7%) patients discontinued dupilumab due to ocular side effects. In the multivariable analysis, older age, history of conjunctivitis, and a baseline Eczema Area and Severity Index (EASI) score ≥ 28 were independent risk factors for developing DAOSD. Using these variables, a risk-scoring system was constructed. The predicted DAOSD risks for AD patients with 0, 1, 2, 3, 4, and 5 points were 5.8%, 14.2%, 30.7%, 54.3%, 76.2%, and 89.6%, respectively.In this study, the patient's age, history of conjunctivitis, and higher baseline EASI score were significantly associated with DAOSD. This risk-scoring system would help identify high-risk patients requiring more caution when initiating dupilumab treatment.

    Keywords: Dupilumab, dupilumab-associated ocular surface disease, DAOSD, atopic dermatitis, Conjunctivitis

    Received: 30 Apr 2024; Accepted: 19 Jul 2024.

    Copyright: © 2024 Shim, Kim, Yee and Gwak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hye Sun Gwak, Ewha Womans University, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.