Association between Dupilumab and Conjunctivitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author:

Lin Tzu-Yi12,Wang Ching-Ya12ORCID,Wang Fang-Ying23ORCID,Kang Eugene Yu-Chuan245ORCID,Hwang Yih-Shiou2467ORCID

Affiliation:

1. Department of Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan

2. School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

3. Department of Dermatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan

4. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan

5. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

6. Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 412, Taiwan

7. Department of Ophthalmology, Xiamen Chang Gung Memorial Hospital, Xiamen 361000, China

Abstract

Conjunctivitis is commonly reported in dupilumab users with atopic dermatitis (AD), and few studies have compared the risk of conjunctivitis among patients with different indications. This study aimed to investigate the association between dupilumab and conjunctivitis in various diseases. The protocol of this study was registered on PROSPERO (ID CRD42023396204). The electronic search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov was conducted for the period from their inception to January 2023. Only placebo-controlled, randomized controlled trials (RCTs) were included. The main outcome was the incidence of conjunctivitis during the study period. The subgroup analysis was performed for patients with AD and non-AD indications, which include asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis. In total, 23 RCTs involving 9153 patients were included for meta-analysis. Dupilumab users exhibited significantly higher risk of conjunctivitis (risk ratio [RR], 1.89; 95% confidence interval [CI], 1.34–2.67) than placebo users. Notably, significantly increased incidence of conjunctivitis was observed in the dupilumab group relative to the placebo group among patients with AD (RR, 2.43; 95% CI, 1.84–3.12) but not among patients with non-AD indications (RR, 0.71; 95% CI, 0.43–1.13). In conclusion, only dupilumab users with AD but not those with non-AD indications reported an elevated incidence of conjunctivitis.

Publisher

MDPI AG

Subject

Pharmaceutical Science

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