Sex- and Age-Related Variations in Symptoms and Signs of Dupilumab-Associated Ocular Surface Diseases in Colombian Patients

BACKGROUND: Dupilumab, approved for treating moderate-to-severe atopic dermatitis (AD), has been linked to a group of ocular surface adverse effects collectively called dupilumab-associated ocular surface diseases (DAOSDs). Although DAOSDs have been described in various populations, data regarding age- and sex-related differences in Latin American cohorts are scarce. This study aimed to describe the frequency and clinical features of DAOSDs in Colombian patients with AD, with a particular focus on variations by age and sex. METHODS: We conducted a cross-sectional study of 56 patients with AD receiving dupilumab. A single ophthalmologist assessed ocular surface parameters, including tear break-up time, superficial punctate keratitis (SPK), and Meibomian gland dysfunction. Conjunctivitis was defined as the appearance of new symptoms after treatment onset and conjunctival hyperemia. Pre- and post-treatment symptoms were compared, and associations with age and sex were analyzed. RESULTS: Conjunctivitis was observed in 32.1% of patients. Pruritus (75%) and redness (53.6%) were the most frequent symptoms. Meibomian gland dysfunction and SPK were present in 46.4% and 41.1%, respectively. No sex-related differences were found. Patients aged ≥20 years showed significantly higher rates of symptoms, MGD, and SPK. CONCLUSION: DAOSDs were frequent, particularly in older patients, supporting the need for early ophthalmologic evaluation.