In a real-world study, patients treated with Tepezza (teprotumumab) for thyroid eye disease had a dramatic response, with a significant reduction in eye protrusion and double vision. Treatment-related adverse events were also mild for most patients, although some patients experienced hearing loss, inflammatory bowel disease, hyperglycemia, and muscle spasms. The results of this study were presented at the American Academy of Ophthalmology’s annual meeting and published in a journal. ophthalmology In September 2023.
In January 2020, the FDA approved Tepezza (teprotumumab-trbw) for the treatment of adults with thyroid eye disease. Thyroid eye disease is a rare condition in which the muscles and fatty tissue behind the eyes become inflamed, causing the eyes to push forward and bulge outward (proptosis). Graves’ disease (hyperthyroidism), an autoimmune disease, can cause thyroid eye disease. Tepezza was developed by Horizon Therapeutics, which was acquired by Amgen in October 2023.
“I’ve never seen anything else with such a dramatic response,” researcher Sarah T. Wester, MD, professor of clinical ophthalmology and researcher at the Bascom Palmer Eye Institute at the University of Miami, said in a presentation. Ta.
She highlighted patients whose exophthalmos and double vision (diplopia) improved significantly, sometimes after just one or two treatments.
In his practice, Dr. Wester typically sees nonresponsive patients with long-term thyroid disease.
Wester and colleagues participated in a multicenter study to evaluate adverse events in patients treated with Tepezza in February 2020 and October 2022. The researchers found that 81.7% of the 131 patients evaluated experienced an adverse event, and the median number of adverse events for these patients was: 4 events. The mean interval between adverse events was 7.9 weeks after the first injection. 46% of patients had at least one persistent adverse event at last follow-up.
Most AEs were mild, but 28.2% of AEs were moderate and 8.4% of AEs were severe. In fact, 12.2% of patients discontinued treatment due to adverse events such as hearing loss, inflammatory bowel disease, hyperglycemia, and muscle spasms.
“We need to talk about adverse events,” she says. “Patients and their families need to be made aware of the risks of hearing loss and possible worsening of inflammatory bowel disease.”
Treatment with Tepezza should be multidisciplinary, Wester said. She works with audiologists and gastroenterologists to help manage adverse events. She also performs baseline testing on patients, especially those with diabetes. She also advises patients to avoid pregnancy for six months after her last infusion.
“We are not used to doing this in ophthalmology when administering infusion therapy, but we need to consider the systemic effects on these patients.”