• Oculoplastics/Orbit

    Review of: Teprotumumab for chronic thyroid eye disease

    Ozzello D, Dallalzadeh L, Lin C. Orbit, June 2021

    Investigators assessed the use of teprotumumab for patients with chronic thyroid eye disease (TED) with a low clinical activity score (CAS).

    Study design

    In this retrospective analysis, researchers assessed 9 patients with long-standing (mean 6.25 years) TED and a low clinical activity score (CAS) of 0 or 1. Patients received more than 9 months of treatment. Primary outcomes were proptosis and eyelid retraction.

    Outcomes

    After treatment, patients experienced significant average reduction in proptosis (4 mm) and eyelid retraction (0.3 mm) in the worse eye. Some patients reported treatment-related myalgia, hair thinning, exacerbated chronic tinnitus, and hyperglycemia.

    Limitations

    The study was retrospective in nature and was not placebo controlled. In addition, several side effects were noted.

    Clinical significance

    Teprotumumab may be an effective addition to our therapeutic armamentarium for patients with chronic thyroid eye disease. While initial studies suggested a role for this medication in new-onset disease, the window to use teprotumumab may be much longer than initially believed. Specifically, patients with long-standing TED and relatively low CAS may still benefit from this therapy while avoiding the need for surgery.