Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Response to Teprotumumab in Thyroid Eye Disease Patients of Long Duration and High Disease Activity
Author: Darren Chen
ePoster Number: 113,00
Purpose
This study aims to evaluate the efficacy of teprotumumab in TED patients with prolonged disease duration and high clinical activity.
Methods
This is a retrospective study of all TED patients who underwent eight infusions of teprotumumab treatment and had a consistently documented clinical activity score (CAS) ≥ 4 for at least 2 years prior to teprotumumab initiation at a single institution. Primary outcome measures included pre-treatment proptosis response (measured by Hertel exophthalmometry), CAS response, and diplopia response (≥1 point improvement in Gorman diplopia score) compared to post-treatment measurements at the immediate follow-up visit using Mann-Whitney U testing. Results were considered significant if p<0.05.
Results
Of 198 patients who initiated teprotumumab treatment from April 1, 2020 to March 31, 2024, 8 patients met inclusion criteria with TED duration greater than 2 years and CAS ≥ 4. Demographic data are shown in table 1; most patients were older (age 63.9), female (87.5%), white (87.5%), and former smokers (50%). The median TED duration measured from first clinic visit to the clinic visit closest to initiation of teprotumumab was 42.3 months, and the average follow up interval post-treatment was 4.9 months. Over 16 eyes from the 8 patients, the median pre-treatment Hertel measurement was 24.25 (IQR 4.88) compared to a post-treatment measurement of 21 (IQR 4.63) (p<0.001), resulting in a mean proptosis reduction percentage of 13.6%. The median pre-treatment CAS was 5 (IQR 1) compared to a post-treatment CAS of 1 (IQR 2.25) (p<0.001). The median pre-treatment diplopia score was 1.5 (IQR 1.25) compared to a post-treatment score of 0.5 (IQR 1.0) (p=0.04). Over an average of 32.7 months of follow-up, one of the eight patients underwent retreatment with teprotumumab.
Conclusion
This retrospective study suggests teprotumumab can be an effective treatment for patients with thyroid eye disease who have prolonged disease duration and high clinical activity. Significant improvements were observed in proptosis, clinical activity score, and diplopia following teprotumumab treatment.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Sierra | Ha | Massachusetts Eye and Ear |
| Tatiana | Rosenblatt | Massachusetts Eye and Ear |
| Amee | Azad | Massachusetts Eye and Ear |
| Sri Meghana | Konda | Massachusetts Eye and Ear |
| Lisa | Lin | Massachusetts Eye and Ear |
| Natalie | Wolkow | Massachusetts Eye and Ear |
| Nahyoung Grace | Lee | Massachusetts Eye and Ear |
| Michael | Yoon | Massachusetts Eye and Ear |
| Suzanne | Freitag | Massachusetts Eye and Ear |
Abstract ID: 25-249
