How did pandemic-related teprotumumab treatment delays impact outcomes?
During the COVID-19 pandemic, the production of teprotumumab was interrupted to divert resources to government-mandated vaccine production resulting in some patients with thyroid eye disease (TED) receiving a shorter treatment regimen. During a presentation at ASOPRS 52nd Annual Fall Scientific Symposium, data from a recent study examining the durability of teprotumumab when patients receive a shorter than 8 dose regimen, were presented.
Researchers analyzed data from 70 patients with active or chronic (defined as CAS < 4 and thyroid eye symptoms longer than 9 months), moderate to severe TED who had completed at least 1 infusion of teprotumumab and had not yet completed all 8 planned infusions. There was a CAS of > 4 in 60 patients and a CAS of < 4 in 10.
Overall, patients completed a mean of 4.2 of teprotumumab infusions before the interruption, and the mean length of follow-up after the last infusion was 9.4 weeks.
The mean decrease in CAS from initiation of treatment to baseline exam in patients with active TED and CAS > 4 at initial presentation was 3.4; these patients had an average CAS increase 0.1 during the interruption (P = 0.6).
A total of 35 active patients had CAS of 0 or 1 at baseline exam. During the interruption, CAS of 0 or 1 was maintained by 35 active patients.
For patients with active TED, the mean change in proptosis from initiation to baseline exam was -2.6 mm and from baseline to last interruption follow-up was -0.2 mm.
All patients with chronic TED maintained CAS < 4. The mean change in proptosis from initiation to baseline exam was -2.5 mm and from baseline to last interruption follow-up was -0.3 mm.
No concurrent TED treatments were needed during the teprotumumab interruption, and no patients developed new optic neuropathy.
Ho T, Maamari R, Couch S, et al. Outcomes of Patients with Thyroid Eye Disease Partially Treated with Teprotumumab. Presented at: ASOPRS 52nd Annual Fall Scientific Symposium.