Incidence, Risk Factors, and Management of Conjunctivitis in Atopic Dermatitis Patients Treated With Dupilumab or Tralokinumab: Results From a Multicenter, Observational, Retrospective Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Conjunctivitis is among the most frequent adverse events (AEs) emerged in clinical trials for all biologic drugs approved for atopic dermatitis (AD). However, real-world comparative data on the incidence, risk factors, and management of conjunctivitis remain limited. OBJECTIVE: We aimed to compare the incidence, clinical features, and management of conjunctivitis in patients with moderate-to-severe AD treated with dupilumab or tralokinumab in a real-life setting. PATIENTS AND METHODS: A multicenter, retrospective, observational study including adult patients with moderate-to-severe AD treated with dupilumab or tralokinumab for at least 16 weeks was carried out. Demographic, clinical, and therapeutic data were collected from 35 dermatological referral centers across Italy. Conjunctivitis incidence, severity, time to onset, and ophthalmologic management were analyzed and compared between treatment groups. RESULTS: A total of 6668 patients were included (5899 on dupilumab and 769 on tralokinumab). Conjunctivitis occurred in 10.76% of dupilumab-treated and 12.61% of tralokinumab-treated patients, with no statistically significant difference in overall incidence. However, time to onset was significantly shorter with tralokinumab than with dupilumab (15.3 ± 14.5 weeks vs. 35.5 ± 45.2 weeks, respectively; p < 0.0001). Ophthalmologic management strategies were similar between groups, mainly involving lubricants and corticosteroid-based eye drops. Dupilumab-treated patients more frequently discontinued or switched treatment due to conjunctivitis than tralokinumab patients (25.4% vs. 14.4%, respectively; p < 0.05). CONCLUSIONS: Conjunctivitis represents a relatively frequent AE in patients with AD receiving dupilumab or tralokinumab. However, earlier onset of conjunctivitis with tralokinumab and higher discontinuation rates with dupilumab suggest differing tolerability profiles. Early recognition of ocular symptoms is essential, and dermatologists should promptly initiate supportive eye care and refer to ophthalmologists when appropriate to avoid unnecessary treatment interruptions.
DOI: 10.1111/ijd.70027
Authors: Luca Potestio, Cataldo Patruno, Marika Del Gaudio, Michela Ortoncelli, Simone Ribero, Francesca Barei, Silvia Mariel Ferrucci, Laura Bonzano, Ilaria Trave, Mario Bruno Guanti, Carlotta Gurioli, Bianca Maria Piraccini, Niccolò Gori, Elena Ippoliti, Ketty Peris, Laura Grigolato, Mariateresa Rossi, Caterina Foti, Paolo Romita, Benedetta Tirone, Eustachio Nettis, Maria Esposito, Maria Concetta Fargnoli, Lina Maria Magnanimi, Elena Pezzolo, Katharina Hansel, Luca Stingeni, Rosanna Satta, Maria Mariano, Flavia Pigliacelli, Flavia Manzo Margiotta, Marco Romanelli, Ruggero Cascio Ingurgio, Antonio Costanzo, Alessandra Narcisi, Monica Corazza, Emiliano Antiga, Pietro Morrone, Pietro Rubegni, Laura Calabrese, Laura Lazzeri, Giovanni Rubegni, Fabrizio Guarneri, Nicola Zerbinati, Andrea Carugno, Rosa Valentina Puca, Oriele Sarno, Claudio Marasca, Emanuela Martina, Francesca di Vico, Maddalena Napolitano
Institutions: Federico II University Hospital, University of Naples Federico II, University of Molise, University of Turin, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Sanitaria Unità Locale di Reggio Emilia, Santa Maria Nuova Hospital, Ospedale Policlinico San Martino, University of Genoa, University of Modena and Reggio Emilia, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, University of Bari Aldo Moro, University of L'Aquila, Ospedale San Bortolo, University of Perugia, University of Sassari, San Gallicano Hospital, University of Pisa, Scuola Superiore Sant'Anna, Humanitas University, IRCCS Humanitas Research Hospital, University of Ferrara, University of Florence, Azienda Sanitaria Provinciale di Cosenza, University of Siena, University of Messina, University of Insubria, Azienda Ospedaliera S.Giuseppe Moscati, Ospedale Antonio Cardarelli, Marche Polytechnic University
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,150
Funders: Università degli Studi di Napoli Federico II, Università Degli Studi di Modena e Reggio Emila, Università degli Studi di Genova, Università di Bologna, Università degli Studi di Torino, Università degli Studi di Brescia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Perugia
OpenAlex ID: W4413384093