{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:41:53Z","timestamp":1780684913743,"version":"3.54.1"},"reference-count":72,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Dupilumab\u2010associated ocular surface disease (DAOSD) is of particular relevance in patients with atopic dermatitis (AD). Guidance on DAOSD assessment and management in the Australian setting is needed to reduce its impact and minimise disruption to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was undertaken to identify data pertaining to the incidence, pathophysiology, risk factors and management of DAOSD. A critical review of this literature was used to inform a decision framework for dupilumab\u2010prescribers and develop a graded severity scoring tool to guide appropriate management options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DAOSD typically emerges within 4\u00a0months of commencing dupilumab and the occurrence of new events diminishes over time. The reported incidence varies widely depending on the nature and source of the data: 8.6\u201322.1% (clinical trials programme), 0.5\u201370% (real\u2010world data; differences in study size, duration of follow\u2010up, ophthalmologist intervention, use of prophylaxis). Occurrence increases with AD severity and in patients with prior history of ocular disease; pathophysiology is still to be fully characterised. Management options have evolved over time and include lubricants\/artificial tears, corticosteroids, calcineurin inhibitors, antihistamines, anti\u2010inflammatory agents and antimicrobial agents. Current therapies aim to resolve symptoms or reduce severity to levels sufficiently tolerable to enable continuation of dupilumab therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recommendations for DAOSD assessment and management include identification of high\u2010risk patients, vigilance for red flags (keratoconus, herpetic and bacterial keratitis), regular assessment of symptom severity (before and during dupilumab therapy), conservative management of mild DAOSD by the prescribing physician and ophthalmologist referral for collaborative care of moderate\u2013severe DAOSD and high\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.13924","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T11:24:42Z","timestamp":1663673082000},"page":"421-436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Dupilumab\u2010associated ocular surface disease: An interdisciplinary decision framework for prescribers in the Australian setting"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-5607","authenticated-orcid":false,"given":"Peter","family":"Foley","sequence":"first","affiliation":[{"name":"Department of Dermatology St Vincent\u2019s Hospital Melbourne  Fitzroy Victoria Australia"},{"name":"Department of Medicine The University Melbourne  Melbourne Victoria Australia"},{"name":"Skin Health Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9567-6630","authenticated-orcid":false,"given":"Yves A.","family":"Kerdraon","sequence":"additional","affiliation":[{"name":"Save Sight Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John 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