Purpose

The purpose of this study is to evaluate the effect of teprotumumab on thyroid-suppressive medication requirements in patients with thyroid eye disease.

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Methods

This retrospective study included 198 patients treated with 8-cycles of teprotumumab at a single institution, of whom 82 were on thyroid-suppressive therapy at the time of treatment initiation. Weekly cumulative dose (mg/week) was recorded at baseline, immediately after treatment, and at 12 months (n=55). Analyses were restricted to methimazole-treated patients (n=79). Paired comparisons were performed using the Wilcoxon signed-rank test. Percent dose reduction (≥25% and ≥50%) was calculated.

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Results

Patients were predominantly female (67.1%), White (73.2%), and without a prior smoking history (64.6%). Mean age was 54.4 years.

Methimazole dose decreased in 50.6% of patients immediately after treatment and 56.4% at 12 months, with few patients requiring increased dosing (8.9% and 9.1%, respectively). The median weekly cumulative methimazole dose decreased from 70 mg/week (IQR 35–140) at baseline to 60 mg/week (IQR 35–96.3) immediately post-treatment and to 35 mg/week (IQR 17.5–105) at 12 months (p<0.001 for both). Immediately after treatment, 45.6% of patients had ≥25% dose reduction, and 32.9% achieved ≥50% dose reduction. At 12 months, 54.5% of patients had ≥25% dose reduction, and 41.8% achieved ≥50% dose reduction.

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Conclusion

Teprotumumab is associated with a statistically significant reduction in methimazole dose requirements immediately and 12 months after treatment.

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Additional Authors

First name	Last name	Base Hospital / Institution
Amee	Azad	Massachusetts Eye And Ear Infirmary
David	Zhao	Massachusetts Eye And Ear Infirmary
Darren	Chen	Massachusetts Eye And Ear Infirmary
Sierra	Ha	Massachusetts Eye And Ear Infirmary
Natalie	Wolkow	Massachusetts Eye And Ear Infirmary
Nahyoung	Lee	Massachusetts Eye And Ear Infirmary
Michael	Yoon	Massachusetts Eye And Ear Infirmary
Suzanne	Freitag	Massachusetts Eye And Ear Infirmary

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