What data exist regarding treatment for conjunctivitis from dupilumab in children <5 years of age?

The long-term dupilumab study in young children (Paller et al., PMID 41926052) showed 19% conjunctivitis (n = 121), all are mild to moderate and did not require treatment. Median time of resolution was 8 days. Therefore, if a young child with more severe conjunctivitis due to dupilumab lasting longer than this, I would consult an ophthalmologist or pause the dupilumab.

The incidence of conjunctivitis in children under 5 years old receiving dupilumab ranges from 5% to 19% in clinical trials and real-world studies, with cases typically being mild and self-limited, lasting on average around 8 days (van der Rijst et al., PMID 40103206, Paller et al., PMID 41926052). In the Phase 3 trials with Dupilumab, the median onset for conjunctivitis symptoms occurred at 79 days with a median duration of 24.5 days; importantly, no patient discontinued dupilumab due to conjunctivitis (Paller et al., PMID 36116481).

Although I am not aware of specific data regarding treatment, the 2023 AAAAI/ACAAI Atopic Dermatitis Guidelines do recommend a stepwise approach to dupilumab-associated conjunctivitis:

• For mild conjunctivitis- ...