Abstract
Purpose :
This study aims to evaluate the efficacy, safety, and the durability of all patients who have completed eight infusions of teprotumumab for thyroid eye disease (TED) seen at a single eye center since its approval.
Methods :
In this retrospective review, all consecutive patients with a clinical diagnosis of TED who had completed 8 infusions of teprotumumab were included with minimum follow up time of 24 weeks since completion of their final infusion. The primary outcome measure was proptosis response ≥2mm after completion of therapy and after 24 weeks of follow-up. Secondary outcome measures included clinical activity score (CAS), diplopia response (reduction of ≥1 on Gorman score), and Barrett’s muscle index (BI) using computed tomography (CT) before and after infusions.
Results :
The study included nineteen patients. The average age ± SD was 60.5±13.8 years and 73.7% of the patients were female. Proptosis response was achieved in 84.2% (16/19) of patients and maintained in 93.8% (15/16) of those at 24 weeks after completion. Patients saw a significant reduction in proptosis both at completion and at follow-up (3.08±1.80mm, p=0.0005) (2.43±1.76mm, p=0.007), and the difference between the two was not significant (p=0.119). A CAS of 0 or 1 was achieved in 17 of 19 patients after completion and maintained in 16 of those 17 patients at 24 week follow up. Diplopia response was seen in 14/19 patients at completion and all maintained response at 24 week follow up. 9 patients completed imaging before and after infusions and saw a reduction in average BI from 59.9% to 39.7% (p<0.0001). 89.5% of patients reported at least one side effect, the most common of which were muscle spasms (11/17), hearing impairment (7/17), and hyperglycemia (4/17).
Conclusions :
The use of teprotumumab for patients with TED is associated with improvement in proptosis, CAS score, and diplopia. Patients who responded to treatment initially were likely to maintain those results through 24 weeks of follow up after infusions have stopped. No new safety issues were discovered and adverse event rates were similar to previous literature.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.