Measuring Health-Related Quality of Life in Thyroid Eye Disease

Sharma, Anu; Stan, Marius N.; Rootman, Dan B.

doi:10.1210/clinem/dgac230

Cited by 4 publications

(2 citation statements)

References 57 publications

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“…TED threatens vision, especially in dysthyroid optic neuropathy and exposure keratopathy [6]. TED imposes psychological and economic burdens on patients and affects their quality of life [7].…”

Section: Introductionmentioning

confidence: 99%

Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease

Liao

Lai

Aljufairi

et al. 2023

JCM

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Objective: To investigate the association of meibomian gland dysfunction (MGD) and ocular surface exposure with tear film instability in untreated thyroid eye disease (TED) patients. Methods: A cross-sectional study of TED patients from September 2020 to September 2022 was conducted. Ocular surface parameters included ocular surface disease index (OSDI), tear meniscus height (TMH), non-invasive tear break-up time (NITBUT), partial blinking rate, lipid layer thickness (LLT), meibomian gland dropout (meiboscore), Schirmer’s test, and corneal punctate epithelial erosions (PEE). Ocular surface exposure was assessed by the margin reflex distances of the upper and lower eyelid (MRD1 and MRD2), the amount of exophthalmos, lateral flare, and lagophthalmos. Results: In total, 152 eyes from 76 TED patients (64 females and 12 males, age 42.99 ± 12.28 years) and 93 eyes from 61 healthy controls (51 females and 10 males, age 43.52 ± 17.93 years) were examined. Compared with control eyes, TED eyes had higher OSDI, TMH, LLT, and PEE; shorter NITBUT; and worse meiboscore (all p < 0.05). They also had larger amounts of exophthalmos, longer MRD1, more lateral flare, and lagophthalmos. Multivariate analysis identified an association of the tear film instability with lagophthalmos (β = −1.13, 95%CI: −2.08, −0.18) and severe MGD in the lower eyelid (β = −5.01, 95%CI = −7.59, −2.43). Conclusions: Dry eye in TED is mainly manifested as evaporative dry eye disease. Severe lower eyelid MGD and worse lagophthalmos were significantly associated with tear film instability in treatment-naive TED patients.

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Section: Introductionmentioning

confidence: 99%

Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease

Liao

Lai

Aljufairi

et al. 2023

JCM

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“…Thyroid eye disease (TED) is an autoimmune condition associated with Graves’ disease affecting approximately 0.1% of the population ( 1 , 2 ). TED can result in altered appearance and other significant symptoms, impacts negatively on patients’ quality of life (QOL) ( 3 , 4 ), and is associated with poor socioeconomic outcomes ( 3 , 5 , 6 ) and excess mortality ( 7 , 8 ). The traditional standard of care for active, moderate-to-severe TED is systemic glucocorticoid, which, however, has limited efficacy, with overall response rates of 23–53% ( 9 ), little impact on proptosis, and a relapse rate of about 20%, although disease inactivation is reported in up to 80% of cases ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Teprotumumab in thyroid eye disease: wonder drug or great divider?

Perros

2023

European Thyroid Journal

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Progress in management of thyroid eye disease (TED) has been slow for many decades. The recent introduction of teprotumumab (TEP) in the therapeutic arena for TED has had a major impact in view of its efficacy, particularly with respect to its ability to reduce proptosis. However, the high cost of TEP, limited availability to patients outside the USA and the lack of data on cost effectiveness are significant barriers to improving the care of patients with TED globally. Recent guidance from authoritative professional organisations deliver different perspectives on the role of teprotumumab in the routine management of patients with TED underscoring the complexities of interpreting the evidence. The advance that teprotumumab undoubtedly represents in managing TED effectively has highlighted inequities faced by patients and uncertainties about appropriate metrics of efficacy. Professional organisations have an important role addressing these problems. Future studies need to focus on optimising the measurement of outcomes and on assessing cost-effectiveness.

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Teprotumumab Related Hearing Loss: A Large-Scale Analysis and Review of Voluntarily Reported Patient Complaints to the Food and Drug Administration (FDA)

McGwin,

Owsley,

Vicinanzo

2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Accumulating case reports and series have suggested that teprotumumab may significantly increase the risk of hearing impairment that, in some cases, does not resolve. This study investigates the association between hearing impairment and teprotumumab use. Methods: A disproportionality analysis was conducted using the United States Food and Drug Administration Adverse Event Reporting System, a publicly accessible database used for postmarketing surveillance and research. All adverse event reports containing the terms “teprotumumab” or “Tepezza” and a similar comparison group from all patients with the same indications for teprotumumab use (e.g., autoimmune thyroiditis, endocrine ophthalmopathy, and hyperthyroidism) but who had not received the drug were selected. Hearing impairment events were identified using the hearing impairment Standardized MedDRA Query. Results: A total of 940 teprotumumab-associated adverse events were identified, including 84 hearing-related adverse events, with the first reported to the Food and Drug Administration in April 2020. A comparison group of 32,794 nonteprotumumab adverse events was identified with 127 hearing-related adverse events reported. Use of teprotumumab in patients with thyroid conditions was associated with a nearly 24-fold (proportional reporting ratio [PRR] 23.6, 95% confidence interval [CI]: 18.1–30.8) increased likelihood of any hearing disorder (p value <0.0001). The association was specifically elevated for a variety of deafness conditions (e.g., bilateral deafness [PRR: 41.9; 95% CI: 12.8–136.9]), Eustachian tube disorders (PRR: 34.9; 95% CI: 4.9–247.4), hypoacusis (PRR: 10.1; 95% CI: 7.6–13.3), and tinnitus (PRR: 8.7; 95% CI: 6.2–12.1). Conclusions: Patients treated with teprotumumab should receive warnings regarding the increased risk of hearing-related impairments and receive audiometry before, during, and after treatment.

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Measuring Health-Related Quality of Life in Thyroid Eye Disease

Cited by 4 publications

References 57 publications

Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease

Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease

Teprotumumab in thyroid eye disease: wonder drug or great divider?

Teprotumumab Related Hearing Loss: A Large-Scale Analysis and Review of Voluntarily Reported Patient Complaints to the Food and Drug Administration (FDA)

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