Thyroid Eye Disease

Some patients with TED need longer to respond to teprotumumab

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Patients with thyroid eye disease (TED) treated with teprotumumab may need longer than 12 weeks to see a clinically significant response, according to a study.

Approximately half of the patients treated with teprotumumab experience significant improvements in proptosis at 6 weeks, according to recent trials, with a small subgroup not having a significant response by week 12.

In this post hoc analysis, data from patients in phase 2 and phase 3 trials treated with teprotumumab (n = 24) or placebo (n = 24) who had a ≤2 mm reduction in proptosis from baseline to week 12 and who completed assessments at weeks 12 and 24 were included.

A clinically significant improvement at week 24 was demonstrated in 63% (15 out of 24) of patients treated with teprotumumab who had no improvement in proptosis at 12 weeks. No patients receiving placebo had a clinically significant improvement in proptosis at 12 weeks or 24 weeks.

At week 12, a significant reduction in CAS (≥2 points) was demonstrated in 92% and 46% of patients in the teprotumumab group and the placebo, respectively. At week 24, 100% and 42%, respectively, achieved significant reduction.

At baseline, 92% patients in the teprotumumab group had a diplopia grade > 0. At week 12 and week 24, improvement in diplopia ≥ 1 grade was achieved by 55% and 73%, respectively.

Ugradar S, Wang Y, Mester T, et al. Teprotumumab for thyroid eye disease: early response is not required for benefit. Eye (Lond). 2022;36(7):1403-1408. doi: 10.1038/s41433-021-01539-5. Epub 2021 Jun 28. PMID: 34183792; PMCID: PMC9232498.