Journal Article

Teprotumumab for Thyroid-Associated Ophthalmopathy

Harris, Gerald J, Tang, Rosa A, Salvi, Mario, Gigantelli, James W, Kahaly, George J, Woodward, Richard M, Fleming, James C, Hayek, Brent R, Shriver, Erin M, Dailey, Roger A, Smith, Terry J, Couch, Steven M, Antonelli, Alessandro, Gabriel, Kathleen, Magni, Guido, Hink, Eric M, Douglas, Raymond S, Goldberg, Robert A, Ezra, Daniel G

2017

Overview

In patients with thyroid-associated ophthalmopathy, responses to treatment are rare and usually minor. Teprotumumab, an antibody to the insulin-like growth factor I receptor, led to significant responses in 69% of patients and to decreased proptosis. Medical therapies for moderate-to-severe thyroid-associated ophthalmopathy (Graves’ orbitopathy) that have proved to be effective and safe in adequately powered, prospective, placebo-controlled trials are lacking. This unmet need is due to the incompletely understood pathogenesis of the disease. 1 Current treatments are inconsistently beneficial and often associated with side effects, and their modification of the ultimate disease outcome is uncertain. 1 – 3 Previous clinical trials, which were rarely placebo-controlled, suggest that high-dose glucocorticoids, alone 3 – 5 or with radiotherapy, 6 , 7 can reduce inflammation-related signs and symptoms in patients with active ophthalmopathy. However, glucocorticoids and orbital radiotherapy minimally affect proptosis and can cause dose-limiting adverse . . .

• Publisher: Massachusetts Medical Society
• Subject: Adult / Aged / Antibodies, Monoclonal - adverse effects / Antibodies, Monoclonal - therapeutic use / Antibodies, Monoclonal, Humanized / Diabetes Complications / Double-Blind Method / Drug dosages / Endocrinology / Exophthalmos - drug therapy / Female / Graves Ophthalmopathy - complications / Graves Ophthalmopathy - drug therapy / Humans / Hyperglycemia - chemically induced / Immunoglobulins / Immunologic Factors - adverse effects / Immunologic Factors - therapeutic use / Inhibitor drugs / Insulin-like growth factors / Intention to Treat Analysis / Logistic Models / Male / Middle Aged / Monoclonal antibodies / Ophthalmology / Pathogenesis / Quality of Life / Receptor, IGF Type 1 - antagonists & inhibitors / Thyroid gland