Teprotumumab therapy shows sustained proptosis improvement in clinical thyroid eye disease

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).

Reference
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.