Incidence, Risk Factors, and Management of Conjunctivitis in Atopic Dermatitis Patients Treated With Dupilumab or Tralokinumab - Results From a Multicenter, Observational, Retrospective Study

Q: What was the main objective of the study?

To compare the incidence, clinical features, and management of conjunctivitis in real-world patients with moderate-to-severe atopic dermatitis treated with dupilumab or tralokinumab.

Q: How did overall conjunctivitis incidence differ between treatments?

Conjunctivitis occurred in 10.76% of dupilumab-treated patients and 12.61% of tralokinumab-treated patients, with no statistically significant difference in overall incidence.

Q: Which treatment showed earlier onset of conjunctivitis?

Tralokinumab showed a significantly shorter time to onset (15.3 ± 14.5 weeks) compared with dupilumab (35.5 ± 45.2 weeks).

Q: What ocular management strategies were used?

Ophthalmologic management strategies were similar between groups, mainly involving lubricants and corticosteroid-based eye drops, with earlier referral to ophthalmologists emphasized when appropriate.

Sep 30, 2026

Uploaded by Liam

Conjunctivitis is a frequent adverse event observed in clinical trials for biologic therapies in atopic dermatitis, yet real-world comparative evidence on its incidence, risk factors, and management remains limited. This multicenter, retrospective observational study compared conjunctivitis incidence, clinical features, timing, severity, and ophthalmologic management in adults with moderate-to-severe atopic dermatitis treated with dupilumab or tralokinumab. Among 6,668 patients, overall incidence was similar, but onset occurred sooner with tralokinumab, while dupilumab was associated with higher discontinuation or switching due to conjunctivitis. Early ocular recognition and prompt supportive eye care are emphasized.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Methods

Study design and population

Results

Conjunctivitis incidence and onset

Ophthalmologic management

Treatment discontinuation and switching

Conclusions

International Journal of Dermatology ORIGINAL ARTICLE OPEN ACCESS Inflammatory Diseases Incidence, Risk Factors, and Management of Conjunctivitis in Atopic Dermatitis Patients Treated With Dupilumab or Tralokinumab: Results From a Multicenter, Observational, Retrospective Study Luca Potestio1 | Cataldo Patruno2 | Marika Del Gaudio1 | Michela Ortoncelli3 | Simone Ribero3 | Francesca Barei4 | Silvia Mariel Ferrucci4 | Laura Bonzano5 | Ilaria Trave6 | Mario Bruno Guanti7 | Carlotta Gurioli8,9 | Bianca Maria Piraccini8,9 | Niccolò Gori10,11 | Elena Ippoliti10,11 | Ketty Peris10,11 | Laura Grigolato12 | Mariateresa Rossi12 | Caterina Foti13 | Paolo Romita13 | Benedetta Tirone13 | Eustachio Nettis14 | Maria Esposito15 | Maria Concetta Fargnoli15 | Lina Maria Magnanimi15 | Elena Pezzolo16 | Katharina Hansel17 | Luca Stingeni17 | Rosanna Satta18 | Maria Mariano19 | Flavia Pigliacelli19 | Flavia Manzo Margiotta20,21 | Marco Romanelli20 | Ruggero Cascio Ingurgio22,23 | Antonio Costanzo22,23 | Alessandra Narcisi22,23 | Monica Corazza24 | Emiliano Antiga25 | Pietro Morrone26 | Pietro Rubegni27 | Laura Calabrese27,28 | Laura Lazzeri27 | Giovanni Rubegni29 | Fabrizio Guarneri30 | Nicola Zerbinati31 | Andrea Carugno32 | Rosa Valentina Puca33 | Oriele Sarno33 | Claudio Marasca34 | Emanuela Martina35 | Francesca di Vico1 | Maddalena Napolitano1 Correspondence: Luca Potestio ([potestioluca@gmail.com](potestioluca@gmail.com)) Received: 21 May 2025 | Revised: 16 July 2025 | Accepted: 11 August 2025 Funding: The authors received no specific funding for this work. 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 moderateto-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 | Luca Potestio and Cataldo Patruno contributed equally to this article.
For affiliations refer to page 305. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermato

FAQs

What was the main objective of the study?

To compare the incidence, clinical features, and management of conjunctivitis in real-world patients with moderate-to-severe atopic dermatitis treated with dupilumab or tralokinumab.

How did overall conjunctivitis incidence differ between treatments?

Conjunctivitis occurred in 10.76% of dupilumab-treated patients and 12.61% of tralokinumab-treated patients, with no statistically significant difference in overall incidence.

Which treatment showed earlier onset of conjunctivitis?

Tralokinumab showed a significantly shorter time to onset (15.3 ± 14.5 weeks) compared with dupilumab (35.5 ± 45.2 weeks).

What ocular management strategies were used?

Ophthalmologic management strategies were similar between groups, mainly involving lubricants and corticosteroid-based eye drops, with earlier referral to ophthalmologists emphasized when appropriate.

Sep 30, 2026

Uploaded by Liam