• Oculoplastics/Orbit

    Review of: Google searches for thyroid eye disease after regulatory approval of teprotumumab

    Strawbridge J, Meer E, Singh P, et al. JAMA Ophthalmology, in press

    Investigators examined the influence of direct-to-consumer advertising for teprotumumab on Internet search behavior pertaining to thyroid eye disease (TED) and teprotumumab.

    Study design

    This cross-sectional study used Google trends to assess monthly search volumes for “TED," “Tepezza,” and “teprotumumab” for the periods January 2004–June 2019 (baseline), June 2019–January 2020 (when the FDA approved teprotumumab), December 2020 (first wave of national television advertisements for teprotumumab), and May 2021 (second wave of national television advertisements for teprotumumab).


    During the period leading up to FDA approval, searches increased by 3–4% each month (33% over the baseline period). In the month of the first wave of advertisements, search volumes increased by 525% over the previous month; the second wave of advertisements correlated with a 640% increase in search volumes over the previous month.


    As the authors write, causal inferences cannot be drawn from these data. Additionally, the search was limited, as study creators looked at searches for the term “TED” only rather than for other terms for this disorder or parts of this disorder such as “Graves ophthalmopathy” or “eyelid edema.”

    Clinical significance

    Patients are more frequently being referred to subspecialty practices to be evaluated for TED (no matter the degree of severity) and potential candidacy for teprotumumab treatment. This may be related to the increased exposure to advertising for both patients and physicians.