RESUMEN
Dupilumab, the first biologic approved for treatment of atopic dermatitis, has demonstrated significant clinical effect and quality of life-enhancing capacity in clinical trials. In these, dupilumab-associated conjunctivitis where reported in a minority of patients. The present case series describe 10 patients treated with dupilumab where eye complications were very common. We have described patient characteristics, including FLG mutations, atopic history and clinical effect of dupilumab. Nine of 10 developed eye-complications, most commonly conjunctivitis (in 7/10). Other adverse events were herpes simplex virus uveitis and varicella-zoster virus meningitis. Although our case series is small, we conclude that dupilumab is an effective treatment option in severe atopic dermatitis, but that the risk of adverse events from the eyes and recurrence of herpes virus infections should be kept in mind. Close collaboration with an ophthalmologist is recommended, especially among patients with severe, long-lasting atopic dermatitis and/or previous eye disease.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Productos Biológicos/efectos adversos , Conjuntivitis/inducido químicamente , Dermatitis Atópica/tratamiento farmacológico , Adulto , Anticuerpos Monoclonales Humanizados , Conjuntivitis/diagnóstico , Conjuntivitis/inmunología , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/inmunología , Infecciones Virales del Ojo/inducido químicamente , Infecciones Virales del Ojo/inmunología , Femenino , Proteínas Filagrina , Herpes Simple/inducido químicamente , Herpes Simple/inmunología , Herpes Simple/virología , Herpes Zóster/inducido químicamente , Herpes Zóster/inmunología , Herpes Zóster/virología , Humanos , Huésped Inmunocomprometido , Masculino , Meningitis Viral/inducido químicamente , Meningitis Viral/inmunología , Meningitis Viral/virología , Persona de Mediana Edad , Infecciones Oportunistas/inducido químicamente , Infecciones Oportunistas/inmunología , Infecciones Oportunistas/virología , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Uveítis Anterior/inducido químicamente , Uveítis Anterior/inmunología , Uveítis Anterior/virología , Adulto JovenRESUMEN
National immunostimulators and interferon inducers (poludan, ridostin, larifan, myelopide, vegetan) in combination with a commercial herpes vaccine (HV) were used for experimental immunization of mice. A 3-fold or greater rise of specific antibody titres was observed after a single immunization of intact BALB/c mice. In experiments in chronically infected animals a single inoculation of HV resulted in a 3-fold rise of specific antibody titres at 6 days postimmunization but not in later periods (20, 30 days). Administration of larifan, an interferon inducer, but not the immunostimulator myelopide, induced a synergic effect in these experiments. Activation of alpha-interferon production was observed early after combined use of HV and immunostimulators. It is concluded that combined experimental use of HV and immunostimulators activated both specific antibody production and interferon production.