Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
The Past, Present, and Future Treatments of Thyroid Eye Disease
Author: Angela Oh
ePoster Number: 154,00
Purpose
Understanding the progression of a disease and its management is essential to advancing future treatment advancements and care. In the case of thyroid eye disease (TED), recognizing the limitations of past treatments highlights the need for and importance of targeted patient-centered care. This may include a combination of symptom-directed immunosuppression to biologically targeted interventions like IGF-1R inhibition. It is important to study the successes and shortcomings of previous therapeutics to better design protocols that anticipate disease progression and improve long-term quality of life.
Methods
We review the evolution of therapeutics for TED including corticosteroids, radiation, surgical interventions, biologics, and gene therapy. We focus on our experience of treating over 250 patients with Teprotumumab and review the pathways of inflammation relevant for the development of targeted therapies.
Results
TED treatment historically focused on palliation and immunosuppression. Treatment began with systemic corticosteroids as first-line, although was limited in its long-term efficacy, dosing, and safety profile. Physicians also trialed orbital radiation as an adjunct, and variable techniques of surgical decompression arose for moderate to severe cases. The landscape made a historic shift with the introduction of teprotumumab, an insulin-like growth factor-1 receptor inhibitor, which showed improvements in proptosis, diplopia, and quality of life in randomized clinical trials. This eventually led to the FDA-approval of Teprotumumab representing a paradigm shift towards targeted molecular intervention specific to the disease process. There is ongoing research on biologics and gene therapy with variable drug administration and dosing that has opened the window for personalized treatments.
Conclusion
TED management has transitioned from generalized immunosuppression to disease-specific targeted therapies. It is critical to refine treatment algorithms and identify optimal timing and dosing of intervention.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Steven | Leibowitz | UCLA |
| Robert | Goldberg | UCLA |
Abstract ID: 25-377
