Longitudinal Glycemic Outcomes in Patients with Thyroid Eye Disease Treated with Teprotumumab
Author: Sierra Ha
Base Hospital / Institution: Massachusetts Eye and Ear, Harvard Medical School
ePoster presentation
Abstract ID: 25-303
Purpose
To assess long-term glycemic trends in thyroid eye disease (TED) patients treated with teprotumumab.
Methods
Retrospective cohort study of TED patients who started teprotumumab and had pre- and post-treatment hemoglobin A1c (HbA1c) measured. Patients were categorized as normoglycemic, prediabetic, or diabetic based on physician documentation or prior recorded HbA1c value meeting American Diabetes Association criteria (normoglycemic: ≤5.6; prediabetes: 5.7–6.4; diabetes: ≥6.5).
Results
67 patients were included: 39 normoglycemic, 18 prediabetic, and 10 diabetic. Median time from first infusion to first post-treatment HbA1c and most recent follow-up was 10.4 (range: 2.7–39.5) and 29.5 months (range: 5–52), respectively. Median HbA1c rose by 0.2 (range: –1.3–2.2) at first post‑treatment measurement and peaked at a 0.3 increase (range: 0–3.6) (p<0.05). Overall, 43% of patients had an HbA1c increase ≥0.5 at any point. Among normoglycemic patients, 41% progressed to prediabetes at a median of 5.6 months after first infusion, with 44% reverting to normoglycemia after a median of 6.6 months from initial rise. Of those with prediabetes, 39% progressed to diabetes at a median of 5 months (range: 3.4–8.4) after first infusion. Of these, 57% returned to baseline prediabetes status with lifestyle management alone at a median of 7.7 months after initial rise. The remaining patients required initiation or adjustment of glucose-lowering medications. Among patients with diabetes, 90% had HbA1c elevations (median peak change: 1.4, range: 0–3.6) at a median of 5.4 months after first infusion. Of those, 89% recovered to baseline HbA1c at a median of 8.6 months after final infusion. Two patients discontinued teprotumumab due to hyperglycemia. No hyperglycemia‑related hospitalizations occurred.
Conclusion
Teprotumumab was associated with HbA1c elevations, especially in patients with preexisting glucose intolerance. Most glycemic abnormalities resolved after treatment completion and were managed without major interventions. Baseline glycemic status can inform monitoring for patients undergoing treatment.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Lisa Y. | Lin | Massachusetts Eye and Ear, Harvard Medical School |
| Carolina | Chiou | Massachusetts Eye and Ear, Harvard Medical School |
| Natalie | Wolkow | Massachusetts Eye and Ear, Harvard Medical School |
| Nahyoung G. | Lee | Massachusetts Eye and Ear, Harvard Medical School |
| Michael K. | Yoon | Massachusetts Eye and Ear, Harvard Medical School |
| Suzanne K. | Freitag | Massachusetts Eye and Ear, Harvard Medical School |
