与哮喘相比，特应性皮炎度普利尤单抗诱导的眼部不良事件的患病率更高：日常实践分析
2024/08/28
摘要
背景：度普利尤单抗已被证明是中重度特应性皮炎(AD)和重度哮喘(SA)的有效治疗方法。然而，缺乏对不良事件(AE)的比较分析，特别是度普利尤单抗相关的眼表疾病(DAOSD)。
目的：这是第一个真实世界的研究，提供了与SA相比，度普利尤单抗与AD相关的AE患病率。次要目的是评估DAOSD的患病率、发病和治疗策略，并评估度普利尤单抗停药率。
方法: 分析了来自两个日常执业登记处的数据，包括接受度普利尤单抗治疗的 AD 和 SA 患者。评估了包括 DAOSD 在内的不良事件。
结果: 总共包括322名AD和148名SA患者。头痛（23.6%）、注射部位反应（10.1%）和流感样症状（13.5%）在SA患者中更为普遍。有趣的是，眼部不良事件在AD患者中明显更为普遍（62.1%，p < 0.001），包括结膜炎（17.1%，p = 0.004）。88% 的 AD 和 47% 的SA眼部AE患者接受了一种或多种眼科治疗。此外，20%的AD和17.6%的SA患者因眼部AE而停止了度普利尤单抗治疗，而这些AD患者中只有65%以及没有SA患者被转诊至眼科医生。
结论: 在这项真实世界研究中，与SA患者相比，AD患者DAOSD的发病率更高，这凸显了医生意识的重要性，尤其是在为AD患者开具度普利尤单抗处方时。相反，这项研究的结果有助于减轻没有共病AD的SA患者对眼部AE的潜在担忧。此外，通过眼科治疗对大多数眼部AE的有效管理表明，度普利尤单抗在日常实践中具有良好的耐受性，并且多学科合作对于在停用度普利尤单抗之前主动管理眼部不良事件至关重要。
Higher prevalence of dupilumab-induced ocular adverse events in atopic dermatitis compared to asthma: A daily practice analysis.
Anne R, Schlösser; Lotte, Bult.
Abstrast
Background: Dupilumab has been shown to be an effective treatment in moderate-to-severe atopic dermatitis (AD) and severe asthma (SA). However, comparative real-world analyses of adverse events (AE), particularly dupilumab-associated ocular surface disease (DAOSD), are lacking.
Objective：This is the first real-world study to provide insight into the prevalence of AEs associated with dupilumab in AD compared with SA. Secondary objectives were to assess the prevalence, onset and therapeutic strategies of DAOSD and evaluate dupilumab discontinuation rates.
Methods: Data from two daily practice registries including AD and SA patients receiving dupilumab treatment were analyzed. Adverse events, including DAOSD, were evaluated.
Results: In total, 322 AD and 148 SA patients were included. Headaches (23.6%), injection site reactions (10.1%), and influenza-like symptoms (13.5%) were more prevalent in SA patients. Interestingly, ocular AEs were significantly more prevalent in AD patients (62.1%, p < 0.001), including conjunctivitis (17.1%, p = 0.004). 88% AD and 47% SA patients with ocular AEs received one or more ophthalmic treatment(s). Additionally, 20% of AD and 17.6% of SA patients discontinued dupilumab treatment due to ocular AEs, while only 65% of these AD and none of these SA patients were referred to an ophthalmologist.
Conclusions：The higher incidence of DAOSD in AD patients compared with SA patients in this real-world study highlights the importance of physician awareness, especially when prescribing dupilumab to AD patients. Conversely, the findings of this study help alleviate potential concerns about ocular AEs in patients with SA who do not have comorbid AD. Furthermore, the effective management of most ocular AEs with ophthalmic treatments suggests favorable tolerability of dupilumab in daily practice, and multidisciplinary collaboration is essential to proactively manage ocular AEs before discontinuing dupilumab.
背景：度普利尤单抗已被证明是中重度特应性皮炎(AD)和重度哮喘(SA)的有效治疗方法。然而，缺乏对不良事件(AE)的比较分析，特别是度普利尤单抗相关的眼表疾病(DAOSD)。
目的：这是第一个真实世界的研究，提供了与SA相比，度普利尤单抗与AD相关的AE患病率。次要目的是评估DAOSD的患病率、发病和治疗策略，并评估度普利尤单抗停药率。
方法: 分析了来自两个日常执业登记处的数据，包括接受度普利尤单抗治疗的 AD 和 SA 患者。评估了包括 DAOSD 在内的不良事件。
结果: 总共包括322名AD和148名SA患者。头痛（23.6%）、注射部位反应（10.1%）和流感样症状（13.5%）在SA患者中更为普遍。有趣的是，眼部不良事件在AD患者中明显更为普遍（62.1%，p < 0.001），包括结膜炎（17.1%，p = 0.004）。88% 的 AD 和 47% 的SA眼部AE患者接受了一种或多种眼科治疗。此外，20%的AD和17.6%的SA患者因眼部AE而停止了度普利尤单抗治疗，而这些AD患者中只有65%以及没有SA患者被转诊至眼科医生。
结论: 在这项真实世界研究中，与SA患者相比，AD患者DAOSD的发病率更高，这凸显了医生意识的重要性，尤其是在为AD患者开具度普利尤单抗处方时。相反，这项研究的结果有助于减轻没有共病AD的SA患者对眼部AE的潜在担忧。此外，通过眼科治疗对大多数眼部AE的有效管理表明，度普利尤单抗在日常实践中具有良好的耐受性，并且多学科合作对于在停用度普利尤单抗之前主动管理眼部不良事件至关重要。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Clin Transl Allergy 2024 Aug;14(8):e12386; 10.1002/clt2.12386. IF: 5.129)
(Clin Transl Allergy 2024 Aug;14(8):e12386; 10.1002/clt2.12386. IF: 5.129)
Higher prevalence of dupilumab-induced ocular adverse events in atopic dermatitis compared to asthma: A daily practice analysis.
Anne R, Schlösser; Lotte, Bult.
Abstrast
Background: Dupilumab has been shown to be an effective treatment in moderate-to-severe atopic dermatitis (AD) and severe asthma (SA). However, comparative real-world analyses of adverse events (AE), particularly dupilumab-associated ocular surface disease (DAOSD), are lacking.
Objective：This is the first real-world study to provide insight into the prevalence of AEs associated with dupilumab in AD compared with SA. Secondary objectives were to assess the prevalence, onset and therapeutic strategies of DAOSD and evaluate dupilumab discontinuation rates.
Methods: Data from two daily practice registries including AD and SA patients receiving dupilumab treatment were analyzed. Adverse events, including DAOSD, were evaluated.
Results: In total, 322 AD and 148 SA patients were included. Headaches (23.6%), injection site reactions (10.1%), and influenza-like symptoms (13.5%) were more prevalent in SA patients. Interestingly, ocular AEs were significantly more prevalent in AD patients (62.1%, p < 0.001), including conjunctivitis (17.1%, p = 0.004). 88% AD and 47% SA patients with ocular AEs received one or more ophthalmic treatment(s). Additionally, 20% of AD and 17.6% of SA patients discontinued dupilumab treatment due to ocular AEs, while only 65% of these AD and none of these SA patients were referred to an ophthalmologist.
Conclusions：The higher incidence of DAOSD in AD patients compared with SA patients in this real-world study highlights the importance of physician awareness, especially when prescribing dupilumab to AD patients. Conversely, the findings of this study help alleviate potential concerns about ocular AEs in patients with SA who do not have comorbid AD. Furthermore, the effective management of most ocular AEs with ophthalmic treatments suggests favorable tolerability of dupilumab in daily practice, and multidisciplinary collaboration is essential to proactively manage ocular AEs before discontinuing dupilumab.
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