RESUMO
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.
Assuntos
Anticorpos Monoclonais/efeitos adversos , Produtos Biológicos/efeitos adversos , Conjuntivite/induzido quimicamente , Dermatite Atópica/tratamento farmacológico , Adulto , Anticorpos Monoclonais Humanizados , Conjuntivite/diagnóstico , Conjuntivite/imunologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/imunologia , Infecções Oculares Virais/induzido quimicamente , Infecções Oculares Virais/imunologia , Feminino , Proteínas Filagrinas , Herpes Simples/induzido quimicamente , Herpes Simples/imunologia , Herpes Simples/virologia , Herpes Zoster/induzido quimicamente , Herpes Zoster/imunologia , Herpes Zoster/virologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Meningite Viral/induzido quimicamente , Meningite Viral/imunologia , Meningite Viral/virologia , Pessoa de Meia-Idade , Infecções Oportunistas/induzido quimicamente , Infecções Oportunistas/imunologia , Infecções Oportunistas/virologia , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/imunologia , Uveíte Anterior/virologia , Adulto JovemRESUMO
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.