Biologics for Thyroid Eye Disease

In this interview from an Oculoplastics Subspecialty Day talk at AAO 2022, Dr. Rona Silkiss discusses the utility of biologics in the treatment of thyroid eye disease, including the current drugs in use—rituximab, tocilizumab, teprotumumab—and those in the pipeline. Many of the new drugs are versions of the same molecules as the current drugs, but may be leaner, faster, perhaps less expensive, and perhaps with fewer side effects. Other new biologics may have different mechanisms of action, such as FcRn inhibitors. A current concern is with the high cost of biologics, which everyone should be concerned about, not just physicians and patients. 

Dr. Silkiss shared these takeaway points from her talk:

• We are on the threshold of using powerful agents to transform how we treat thyroid eye disease, which will enable us to make chronic disease an extinct entity and to treat patients very early in the course of the disease.
• These powerful molecules treat the local effects of the disease but also have wide-ranging systemic effects, and therefore comorbidities must be kept in mind when choosing specific drugs, they must be used with care, and patients should be engaged in the decision-making.