Higher prevalence of dupilumab-induced ocular surface disease in Atopic Dermatitis compared to Asthma patients: a real life, observational study.

<bold>Background:</bold> Dupilumab has shown to be effective in moderate-to-severe atopic dermatitis (AD) as well as severe uncontrolled asthma (SA) and is often well tolerated. However, real-world data on differences in adverse events (AE), particularly dupilumab associated ocular surface disease (DAOSD), are limited. <bold>Aim:</bold> To investigate AEs of dupilumab treatment, with a focus on DAOSD, in AD patients compared to SA patients in daily practice. <bold>Methods:</bold> Data from two daily practice registries were used to study AD and SA patients receiving dupilumab treatment. Baseline characteristics and AEs with a focus on ocular AEs were recorded. <bold>Results:</bold> A total of 322 AD and 148 SA patients were included. Headache, injection site reaction, and influenza-like symptoms were more prevalent in SA patients, whereas head-neck dermatitis was reported more frequently in AD patients. Ocular AEs were significantly more prevalent in AD patients (62.1%, p<0.001), including conjunctivitis (17.1%, p=0.004). 89% AD and 47.0% SA patients with ocular AEs received one or more ophthalmic treatment(s). In addition, 38% AD and 25.5% SA patients were referred to an ophthalmologist. 20% AD and 17.6% SA patients discontinued dupilumab treatment due to ocular AEs. <bold>Conclusions:</bold> Ocular AEs are more prevalent in AD patients compared to SA patients treated with dupilumab. Most ocular AEs are effectively controlled with ophthalmic treatments and only a small number of patients discontinue dupilumab treatment.