Teprotumumab therapy shows sustained proptosis improvement in clinical thyroid eye disease

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Teprotumumab therapy has shown significant effectiveness in reducing proptosis in patients with clinical thyroid eye disease (TED), with nearly 90% of patients experiencing initial improvement after treatment, according to a study.

However, the study also found that about two-thirds of patients experienced regression, typically within the first year after treatment, with some cases continuing to worsen over subsequent follow-up visits. Despite this, most patients maintained some level of proptosis reduction compared to before treatment.

The study included 119 patients with a mean follow-up period of 10.56 months. After undergoing eight teprotumumab infusions, 87.39% of patients showed initial improvement in proptosis.

Among the 78 patients with multiple follow-up visits, 65.38% exhibited proptosis regression, averaging 12.78% (range: 1.85-58.82%) compared to immediately post-treatment, or 2.43 mm (0.5-10.0 mm).

The study revealed that 8 eyes (7.84%) documented regression more than a year after treatment, while 39.22% showed regression between 6 months and 1 year post-treatment. In addition, 52.94% of eyes exhibited regression within 6 months, with 46.30% of these cases continuing to worsen over subsequent follow-up visits.

It was observed that 25.64% of eyes showed more proptosis at their most recent follow-up compared to before teprotumumab therapy, with an average regression of 1.53 mm (0.5-4.0 mm) or 7.74% (1.85-20.69%) of pretreatment proptosis. Conversely, 63.46% of eyes maintained improvement, with a reduction averaging 3.13 mm (0.5-11.0 mm) or 13.19% (1.92-41.67%) of pretreatment proptosis. The difference between the 2 groups was statistically significant (P < 0.001).

Rosenblatt TR, Chiou CA, Yoon MK, et al. Proptosis Regression After Teprotumumab Treatment for Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg. 2023;doi: 10.1097/IOP.0000000000002531. Epub ahead of print. PMID: 37791840.