What question did this study set out to answer?

The aim is to compare ocular outcomes and conjunctival microbiology in patients with moderate-to-severe atopic dermatitis treated with either dupilumab or upadacitinib.

May 10, 2026Journal of Dermatological Treatment0 citationsOpen Access

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Distinct ocular safety profiles of dupilumab and upadacitinib in atopic dermatitis: a real-world study with ophthalmological and microbiological assessment

PSPaulina StepinskaMedical University of Silesia KZKamila Zawadzińska-HalatMedical University of Silesia MPMaciej PastuszczakMedical University of Silesia

Key Points

The aim is to compare ocular outcomes and conjunctival microbiology in patients with moderate-to-severe atopic dermatitis treated with either dupilumab or upadacitinib.
Prospective real-world study
Adult patients treated with dupilumab or upadacitinib evaluated at baseline and after 16 weeks
Ocular assessments included Ocular Surface Disease Index and Schirmer test, along with conjunctival swabs for culture.
Dupilumab was linked to more frequent conjunctivitis and worsening ocular symptoms.
Schirmer test results and bacterial colonization did not differ significantly between dupilumab and upadacitinib groups.
Both treatments showed comparable dermatological efficacy.

Abstract

BACKGROUND: Dupilumab is highly effective in atopic dermatitis (AD) but is associated with ocular surface disease, whereas Janus kinase (JAK) inhibitors may have a more favorable ocular safety profile. OBJECTIVES: To compare ocular outcomes and conjunctival microbiology in patients with moderate-to-severe AD treated with dupilumab versus upadacitinib. METHODS: In this prospective real-world study, adult patients were treated with dupilumab or upadacitinib and evaluated at baseline and after 16 weeks. Ocular assessment included the Ocular Surface Disease Index (OSDI) and Schirmer test. Conjunctival swabs were collected for culture. Dermatological outcomes were assessed using EASI and DLQI. RESULTS: < .001). Schirmer test results and bacterial colonization did not differ between groups. CONCLUSIONS: Dupilumab and upadacitinib showed comparable dermatological efficacy but distinct ocular safety profiles. Dupilumab was associated with more frequent conjunctivitis and worsening ocular symptoms.

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Cite This Study

Stepinska et al. (Fri,) studied this question.

synapsesocial.com/papers/6a0020cec8f74e3340f9b96d https://doi.org/https://doi.org/10.1080/09546634.2026.2667680

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