Treatment With Doxycycline for Severe Bortezomib-Associated Blepharitis

Severe blepharitis has been implicated as an adverse event of bortezomib (Velcade), used for the treatment of multiple myeloma and mantle cell lymphoma. Bortezomib-associated blepharitis is often refractory to conservative treatment (eyelid hygiene or topical antibiotics) and therefore can have a profound impact on the quality of life, necessitating premature cessation of treatment with bortezomib. We present 2 cases with severe bortezomib-induced blepharitis who were successfully treated with oral doxycycline (100 mg/day) in combination with topical antibiotics, allowing continuation of bortezomib. Oral doxycycline is well-tolerated, safe for long-term use, and inexpensive. It represents an effective treatment of the severe ocular side effects of bortezomib. The prolonged use of oral doxycycline in refractory cases of bortezomib-induced blepharitis should be considered. Awareness of this treatment option is important for both ophthalmologists and medical professionals treating patients with bortezomib-induced blepharitis. (C) 2016 Elsevier Inc. All rights reserved.