{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:43:01Z","timestamp":1789612981159,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dupilumab\u2010associated ocular surface disease (DAOSD) is a common side effect in paediatric atopic dermatitis (AD) patients treated with dupilumab. However, long\u2010term real\u2010world safety data is limited. Therefore, this study investigates the incidence of DAOSD in paediatric AD patients treated with dupilumab and identifies associated risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study included paediatric AD patients (aged 3\u201317\u2009years) treated with dupilumab. Ocular symptoms were assessed every 4\u201312\u2009weeks. DAOSD was initially treated with lubricating eye drops, antihistamine eye drops, and\/or tacrolimus ointment for the external eyelids. Persistent symptoms were treated with ocular anti\u2010inflammatory therapy. Ophthalmological examination was performed in patients with DAOSD requiring ocular anti\u2010inflammatory therapy. Univariable and multivariable regression analyses were conducted to identify predictors for developing DAOSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 104 patients (11.7\u2009\u00b1\u20094.0\u2009years) with a median follow\u2010up of 70.5\u2009weeks were included. Overall, 34.6% (36\/104) of patients developed DAOSD, of which 30.6% (11\/36) required ocular anti\u2010inflammatory therapy. The development of DAOSD was not age\u2010dependent, nor was it associated with pre\u2010existing allergic conjunctivitis. The most common ocular symptoms were pruritus (75.0%), redness (72.2%), and tearing (58.3%). Ophthalmological examination revealed tarsal conjunctivitis in all patients with DAOSD requiring ocular anti\u2010inflammatory therapy. Baseline serum IgE levels of \u2265\u20093000 kU\/L were independently associated with the development of DAOSD (OR 4.65; 95% CI 1.43\u201315.11, <jats:italic>p\u2009=<\/jats:italic>\u20090.011). DAOSD led to dupilumab discontinuation in 3.8% (4\/104) of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This prospective, long\u2010term, real\u2010world study shows that 34.6% of paediatric AD patients treated with dupilumab develop DAOSD. Elevated baseline serum IgE (\u2265\u20093000 kU\/L) may predict the development of DAOSD. The high incidence of DAOSD underscores the importance of awareness of ocular symptoms during dupilumab treatment, especially in (young) paediatric patients, where reporting ocular symptoms can be challenging and may lead to delayed diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.70025","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T05:16:08Z","timestamp":1742361368000},"page":"391-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Dupilumab\u2010Associated Ocular Surface Disease in Paediatric Atopic Dermatitis Patients: Results From the <scp>BioDay<\/scp> Registry"],"prefix":"10.1111","volume":"55","author":[{"given":"Lisa P.","family":"van der Rijst","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Department of Dermatology and Allergology Utrecht University  Utrecht the Netherlands"},{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal M.","family":"van Luijk","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"van der Kamp","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaas P. A.","family":"Zuithoff","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joke H.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein S.","family":"de Bruin\u2010Weller","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9004-5111","authenticated-orcid":false,"given":"Marlies","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of 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