Abstract Listings 2024

Purpose

Prior studies of teprotumumab for thyroid eye disease report proptosis reduction in millimeters, which does not fully capture teprotumumab’s clinical effect since a given number of millimeters change can be of variable impact depending on patients’ degree of pre-treatment proptosis. This study evaluated proptosis change as a percentage of pre-treatment proptosis to better understand teprotumumab’s clinical impact.

Methods

A retrospective study of all patients who completed eight teprotumumab infusions at one institution from 1/1/2020 to 12/31/2022. Primary outcome was proptosis reduction after teprotumumab as a percentage of pre-treatment proptosis.

Results

Of 119 patients, 208 (87.39%) eyes of 110 patients had proptosis reduction averaging 14.35% (range 2.22 – 40.48%) or 3.31 mm (0.5 – 10.0 mm). Every 1-mm increase in pre-treatment proptosis increased odds of reduction by 3.05% (p<0.001) and increased reduction amount by 1.20% (p<0.001). Patients with thyroid eye disease onset within two years of teprotumumab had higher mean proptosis reduction than those with longer disease duration (12.91% vs. 9.39%, p=0.008). Reduction did not vary by race, smoking status, or sex, except in patients with severe initial proptosis wherein women had greater mean proptosis reduction than men (15.97% vs. 9.74%, p=0.021).

Conclusion

This is the first study to report proptosis reduction as a percentage of pre-treatment proptosis, providing a better understanding of the clinical impact of teprotumumab. Proptosis reduction increased with shorter disease duration, older age, higher Clinical Activity Score, and greater initial proptosis.

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