Expert Consensus on the Use of Teprotumumab for the Management of Thyroid Eye Disease Using a Modified-Delphi Approach

Douglas, Raymond S.; Kossler, Andrea L; Abrams, Jody; Briceño, César A.; Gay, David; Harrison, Andrew R.; Lee, Michael; Nguyen, John; Joseph, Shannon S.; Schlachter, Dianne; Tan, Jeremy; Lynch, Judah; Oliver, Louisa; Perry, Richard; Ugradar, Shoaib

doi:10.1097/wno.0000000000001560

Cited by 11 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent consensus paper from 15 TED experts based in the USA recommended that teprotumumab be considered as the first-line treatment in adults with significant TED (i.e. CAS ≥ 4, proptosis ≥ 3 mm above normal, intermittent or constant diplopia, moderate or severe soft tissue involvement, or orbital pain and/or pressure) [ 40 ]. Recommendations also included the consideration of teprotumumab in the treatment of patients with CAS < 3, lid retraction ≥ 2 and mild compressive optic neuropathy (CON) with close monitoring.…”

Section: Current Status Of Teprotumumab In the Management Of Thyroid ...mentioning

confidence: 99%

“…Recommendations also included the consideration of teprotumumab in the treatment of patients with CAS < 3, lid retraction ≥ 2 and mild compressive optic neuropathy (CON) with close monitoring. Teprotumumab was considered suitable for patients with TED for longer than 16 months and may be appropriate as a single therapy for the primary treatment of mild CON with timely initiation and close monitoring, but not for the primary treatment of severe CON [ 40 ]. As the cost of teprotumumab is manyfold greater than historical treatments for TED and may be a limiting factor in its use, cost analyses may be of benefit [ 41 ].…”

Section: Current Status Of Teprotumumab In the Management Of Thyroid ...mentioning

confidence: 99%

See 1 more Smart Citation

Teprotumumab: A Review in Thyroid Eye Disease

Nie

Lamb

2022

Drugs

View full text Add to dashboard Cite

Teprotumumab (TEPEZZA ® ), a monoclonal antibody that inhibits the insulin-like growth factor 1 receptor (IGF-1R), is the first disease-modifying therapy approved for the treatment of thyroid eye disease (TED) in the USA. In phase II and III clinical trials in adults with active, moderate-to-severe TED, intravenous teprotumumab significantly improved proptosis response rate and a range of other TED outcomes, including overall response rate, Clinical Activity Score, diplopia and disease-specific quality of life. The clinical benefit of teprotumumab was maintained for up to 51 weeks post-treatment in the majority of patients. Teprotumumab was generally well tolerated; adverse events with the greatest risk difference compared with placebo were muscle spasms, hearing loss and hyperglycaemia. Early real-world experience suggests teprotumumab may also be beneficial in a more diverse TED population. Teprotumumab is the first approved treatment for TED and is effective at reducing symptoms which are often unamenable to historical pharmacological interventions. While further data are required, current evidence suggests teprotumumab represents an important advance in the treatment of TED. Supplementary Information The online version contains supplementary material available at 10.1007/s40265-022-01804-1.

show abstract

Section: Current Status Of Teprotumumab In the Management Of Thyroid ...mentioning

confidence: 99%

Section: Current Status Of Teprotumumab In the Management Of Thyroid ...mentioning

confidence: 99%

Teprotumumab: A Review in Thyroid Eye Disease

Nie

Lamb

2022

Drugs

View full text Add to dashboard Cite

show abstract

“…Recent consensus guidance has been provided by a group of ophthalmologists who treat TAO. 102 Clearly those experts consider the use of teprotumumab in a subset of patients to be appropriate. As they and others have noted, the drug is associated with side effects and some patients fail to respond adequately to the 8-infusion treatment protocol frequently employed.…”

Section: Potential For Increasingly More Effective Tao Therapiesmentioning

confidence: 99%

Fibrocyte Participation in Thyroid-Associated Ophthalmopathy Suggests New Approaches to Therapy

Smith

2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: Review the historical context of research and changing therapeutic landscape of thyroid-associated ophthalmopathy (TAO) by focusing on the relationship between TAO, CD34+ fibrocytes, thyrotropin receptor (TSHR), and insulin-like growth factor-I receptor (IGF-IR). Methods: A literature review using search terms, including fibrocytes, IGF-IR, TSHR, TAO, and thyroid eye disease. Results: The mechanisms involved in TAO have been partially identified. Substantial progress has been made over several decades, including 1) recognizing the interplay between the professional immune system and orbital tissues; 2) TSHR and IGF-IR act interdependently in mediating the pathogenesis of TAO; 3) Multiple cytokines and specific immune cells are involved in activating and remodeling orbital tissue; 4) Recognition of these mechanisms is allowing the development of target therapies such as teprotumumab, a monoclonal antibody IGF-IR inhibitor approved by the US Food and drug administration for treatment of TAO; and 5) It appears that teprotumumab acts on the systemic immune system peripheral to the orbit. Conclusion: Additional molecules targeting IGF-IR and other plausible disease mechanisms are currently under development. This activity in the TAO therapeutic space portends even greater improvements in patient care.

show abstract

“…While strong evidence has supported the use of the IGF-1 receptor ligand teprotumumab for moderate-to-severe thyroid-associated ophthalmopathy (TAO), its cost and risk profile are such that it is not recommended for patients with mild disease (1). In fact, therapy for mild TAO is mostly conservative, including artificial tears, botulinum toxin for lid retraction, and prismatic therapy for diplopia.…”

Section: Commentsmentioning

confidence: 99%