Abstract
Purpose :
Teprotumumab (Tepezza) is an insulin-like growth factor 1 receptor antagonist that was recently approved for the treatment of Thyroid Eye Disease (TED), a potentially sight-threatening and debilitating orbital inflammatory disease. Despite the relative safety of Teprotumumab, a risk of hyperglycemia was identified. We seek to identify to what extent Teprotumumab causes hyperglycemia in order to clarify current guidelines for monitoring of hyperglycemia as an adverse side effect of Teprotumumab.
Methods :
A retrospective chart review was performed on patients with TED seen at two large academic teaching hospitals from August 2021 to June 2023. We identified 211 patients with TED, of which 42 received Teprotumumab therapy. Demographics, blood glucose (BG) levels, and HbA1c levels were collected. BG levels were averaged across multiple visits.
Results :
The mean age was 58.2±13.08 years. 71.4% (30/42) were female and 30% (12/42) were male. 21.4% (9/42) were White, 16.7% (7/42) were African American, 19% (8/42) were Asian, and 42.9% (18/42) were other/unreported. For baseline glycemic status, as reported or measured by HbA1c, 84.4% (27/42) were normoglycemic, 16.3% (7/42) had pre-diabetes, and 20.9% (9/42) had diabetes. The mean BG level was 137.1±75.8. Hyperglycemic events (BG≥140 or reported) while taking Teprotumumab were significantly associated with baseline diabetes status (p<0.0001). Of the 10 patients with reported hyperglycemic events during Teprotumumab therapy, 70% (7/10) had diabetes, 10% (1/10) had pre-diabetes, and 20% (2/10) were non-diabetic.
Conclusions :
This study suggests that baseline diabetes status is significantly associated with hyperglycemic events while taking Teprotumumab. Those with pre-diabetes or diabetes may be at increased risk of teprotumumab-related hyperglycemia. Future studies will be necessary to guide current screening and management of teprotumumab-related hyperglycemia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.