# Dupilumab-Associated Ocular Surface Disease in a Local Asian Chinese Population

## TL;DR

This study examines the occurrence and features of eye-related side effects from dupilumab in an Asian Chinese population, finding mild symptoms and a possible protective effect from prior eye allergies.

## Contribution

The study provides insights into dupilumab-associated ocular surface disease in an underrepresented Asian Chinese cohort.

## Key findings

- 25.6% of patients developed dupilumab-associated ocular surface disease (DAOSD), with symptoms like itching and dry eye.
- Prior allergic eye disease was significantly associated with a lower risk of DAOSD.
- No patients discontinued dupilumab due to DAOSD, and symptoms were mostly mild.

## Abstract

Background: This is a retrospective study evaluating the incidence, clinical characteristics, and risk factors of dupilumab-associated ocular surface disease (DAOSD) in a local Asian Chinese population.

Methodology: A retrospective study of patients prescribed dupilumab for AD between January 2020 and May 2025 at a regional hospital. DAOSD was defined as new-onset ocular surface symptoms post-treatment. Statistical analysis included descriptive statistics, binary logistic regression (age, sex, scoring atopic dermatitis (SCORAD), treatment duration/dosage), and Fisher’s exact test for categorical variables (IBM SPSS v22, IBM Corp., Armonk, NY).

Results: Of 43 included patients (mean age: <25 years, 83.7%; mean treatment duration: 418 days), 11 (25.6%) developed DAOSD (mean onset: 1.67 months). Symptoms were mild (itching, 8, 81.8%; redness, 5, 45.5%; dry eye, 4, 36.4%); 10 (90.9%) required only topical lubricants/antihistamines. No patients discontinued dupilumab due to DAOSD. Logistic regression showed no significant associations between DAOSD and age, sex, SCORAD, dosage, or duration (P > 0.05). However, Fisher’s test revealed a significant protective association with prior allergic eye disease (0% DAOSD vs. 33.3% in those without; P = 0.043).

Conclusions: The incidence of DAOSD in this Asian cohort was slightly lower than that in Caucasian populations, with predominantly mild symptoms. Prior allergic eye disease may confer protection against DAOSD, possibly due to prophylactic ocular therapies. Larger studies are needed to validate these findings.