Purpose

Thyroid eye disease (TED) is a progressive autoimmune disorder characterized by inflammation, swelling, and tissue expansion of the orbit. Patients with chronic moderate-to-severe TED often require surgeries, but the associated burden remains poorly characterized. This study described surgery patterns, timing and complications in chronic moderate-to-severe TED.

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Methods

This retrospective cohort study utilized closed claims from the MORE2 Registry and 100% Medicare Fee-for-Service (FFS) databases spanning 1/1/2014 to 31/12/2023 (FFS) and 30/06/2024 (MORE2). Adult patients with >1 claims for thyrotoxicosis and a TED-associated eye condition within 12 months preceding or following the earliest thyrotoxicosis diagnosis, ≥1 claim for a moderate-to-severe treatment at baseline, and an orbital decompression, strabismus or eyelid surgery (index date) were included.

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Results

A total of 1,097 patients met inclusion criteria (mean [SD] age 65.1 [13.8], 72.2% female, 71.2% White) and mean (SD) follow-up was 47.5 (26.9) months. Overall, 40.8% of patients received one surgery, 22.8% two surgeries, 12.9% three surgeries and 23.4% four or more surgeries. The Kaplan-Meier median time from the earliest TED-associated eye condition to the first surgery was 359 days, with 81.4% receiving their first surgery event within 24 months. The median time between first and second surgery events was 548 days and between the second and third surgery events 456 days. Within 90 days of a surgical event, 92.1% of patients experienced at least one complication.

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Conclusion

This study highlights the substantial clinical burden of TED-related surgeries, which are common, recurrent and often associated with complications.

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Additional Authors

First name	Last name	Base Hospital / Institution
Christina	Giannopoulou	Amgen
Alexandra	Eddy	Amgen
Laura	Moore-Schiltz	Inovalon
Emma	Pennington	Inovalon
Laurence	Gozalo	Inovalon
Ada	Kumar	Amgen

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