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dc.contributor.advisor곽혜선-
dc.contributor.author심선영-
dc.creator심선영-
dc.date.accessioned2024-08-19T16:31:40Z-
dc.date.available2024-08-19T16:31:40Z-
dc.date.issued2024-
dc.identifier.otherOAK-000000232244-
dc.identifier.urihttps://dcollection.ewha.ac.kr/common/orgView/000000232244en_US
dc.identifier.urihttps://dspace.ewha.ac.kr/handle/2015.oak/268869-
dc.description.abstract배경 Dupilumab은 아토피 치료를 위한 최초의 생물학적제제로 안구부작용은 dupilumab의 치료기간 동안 가장 빈번하게 보고되는 부작용이다. 이 연구의 일차 목적은 dupilumab 관련 안구부작용의 위험을 예측하기 위한 위험점수시스템을 도입하는 것이고, 이차 목적은 dupilumab의 유효성을 평가하는 것이다. 방법 이 연구는 2019년 4월부터 2023년 9월까지 여의도성모병원에서 dupilumab을 투여한 성인 아토피 환자를 후향적으로 분석하였다. Dupilumab 관련 안구부작용의 위험인자를 평가하기위해 로지스틱 회귀분석을 시행하였고 이를 바탕으로 위험점수시스템을 구축하였다. 결과 Dupilumab으로 치료한 97명의 환자 중 28명에서 안구부작용이 발생하였다. 로지스틱 회귀분석 결과 나이가 많을수록, 결막염 병력이 있는 경우, dupilumab 투여 전 Eczema Area and Severity Index (EASI) 점수가 28점 이상인 경우 안구부작용 발생이 유의하게 높았다. 이러한 위험인자들을 포함하여 위험점수시스템을 구축하였고 0, 1, 2, 3, 4, 5점은 각각 5.8%, 14.2%, 30.7%, 54.3%, 76.2%, 89.6%까지 dupilumab 관련 안구부작용의 위험을 예측하였다. 유효성 측면에서 dupilumab은 16주에 EASI 점수를 유의하게 감소시켰으며, 52주까지 효과를 보였다. 결론 이 연구에서 환자의 나이, 결막염 병력, EASI 점수가 dupilumab 관련 안구부작용과 유의하게 관련되어 있었다. 이 위험점수시스템을 이용하여 dupilumab 투여 환자에서 안구부작용 발생 위험이 높은 환자를 예측하는데 도움을 줄 수 있을 것으로 기대된다.;Background Dupilumab is the first biological treatment for atopic dermatitis (AD). Dupilumab-associated ocular surface disease (DAOSD) is one of the most reported side effects in patients with AD during dupilumab treatment. The primary aim of this study was to identify risk factors for DAOSD in a real-world setting and construct a risk-scoring system for predicting DAOSD risk. The secondary aim was to evaluate the efficacy of dupilumab. Methods A retrospective analysis was conducted for dupilumab-treated adult patients with AD between April 2019 and September 2023 at Yeouido St. Mary's Hospital in Korea. Patients aged ≥ 18 years who received dupilumab to treat AD were included. To determine independent risk factors for DAOSD, we performed univariate and multivariable logistic regression analyses. We developed a risk scoring system for predicting DAOSD risk based on the adjusted odds ratio of significant variables. Results Of the 97 dupilumab-treated patients, 28 (28.9%) developed DAOSD. In the multivariable analysis, older age, history of conjunctivitis, and a baseline Eczema Area and Severity Index (EASI) score ≥ 28 were independent risk factors for developing DAOSD. Using these variables, a risk-scoring system was constructed. The predicted DAOSD risks for AD patients with 0, 1, 2, 3, 4, and 5 points were 5.8%, 14.2%, 30.7%, 54.3%, 76.2%, and 89.6%, respectively. In terms of efficacy outcome, dupilumab significantly decreased EASI scores at 16 weeks, and it showed effectiveness up to 52 weeks. Conclusion In this study, the patient’s age, history of conjunctivitis, and higher baseline EASI score were significantly associated with DAOSD. This risk-scoring system would help identify high-risk patients requiring more caution when initiating dupilumab treatment.-
dc.description.tableofcontentsI. Introduction 1 II. Methods 3 A. Study patients 3 B. Dupilumab administration and study outcomes 4 C. Data collection 5 D. Statistical analysis. 6 III. Results 7 A. Baseline characteristics of patients 7 B. Dupilumab-associated adverse drug events. 10 C. DAOSD symptoms and manifestations. 13 D. Risk factors associated with DAOSD 14 E. Multivariable analysis to predict DAOSD risk 18 F. Risk scoring system to predict DAOSD risk 20 G. Efficacy of dupilumab treatment. 23 IV. Discussion 25 V. Conclusion 30 Reference 31 Appendix 37 Abstract (in Korean) 39-
dc.formatapplication/pdf-
dc.format.extent517676 bytes-
dc.languageeng-
dc.publisher이화여자대학교 대학원-
dc.subjectdupilumab, dupilumab-associated ocular surface disease, atopic dermatitis-
dc.subject.ddc600-
dc.titleEvaluation of Dupilumab-Associated Ocular Surface Disease in Adult Patients with Atopic Dermatitis-
dc.typeDoctoral Thesis-
dc.creator.othernameShim, Sunyoung-
dc.format.pagev, 42 p.-
dc.identifier.thesisdegreeDoctor-
dc.identifier.major대학원 약학과-
dc.date.awarded2024. 8-
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