Effects of Teprotumumab and Role of Human Leukocyte Antigens Markers in Patients With Thyroid Eye Disease
Authors' conclusion
Patients with both acute and chronic thyroid eye disease treated with teprotumumab had a significant reduction in thyroid stimulating immunoglobulin and thyrotropin receptor antibody levels and improvement in proptosis, clinical activity score, retinal nerve fiber layer and ganglion cell analysis thickness, and intraocular pressure. HLA may predict responders vs nonresponders. Further studies with longer duration and larger population comparing teprotumumab with steroids or other immunomodulatory agents (tocilizumab, rituximab, etc) may be helpful.
Study context
- Population
- Patients aged 18–76 years with TED (acute and chronic)included in final analysis
- Participants
- 26 patients
- Exposure
- Before vs after teprotumumab treatment
- Outcome
- Change in proptosis before and after teprotumumab treatment
Methodological detailssingle-group
- Single-group
Main finding
As reported in the abstract
- Significant reduction in proptosis after teprotumumab
Observational data: associations, not effects.
Secondary outcomes
Ophthalmic measures
- Significant reduction in clinical activity score, retinal nerve fiber layer thickness, ganglion cell analysis and intraocular pressure
Thyroid and metabolic laboratory tests
- Significant decrease in thyroid stimulating immunoglobulin and TRAb levels
- Significant increases in HbA1c, fasting glucose and total T3
Human leukocyte antigens (HLA) markers and response
- HLA haplotypes distinct between responders and nonresponders; HLA-DRB3 02:02:01G, HLA-DRB4 neg and HLA-DQB1 02:01:01G with better response; HLA-A 23:01:01G strongly correlated with nonresponse
Original publication
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