Medical Therapy in Patients with Moderate to Severe, Steroid-Resistant, Thyroid Eye Disease
Authors' conclusion
Teprotumumab and tocilizumab improved inflammation in patients with moderate to severe TED who had failed previous steroid therapy. Additionally, the teprotumumab cases demonstrated similar improvement in proptosis and diplopia to the teprotumumab controls.
Study context
- Population
- Patients with moderate to severe steroid-resistant thyroid eye disease (TED), 2018–2022; mean age 57 years, median TED duration 11.5 months
- Participants
- 37 patients
- Comparison
- Teprotumumab or tocilizumab in steroid-resistant TED (cases) vs steroid-naïve patients on teprotumumab (controls)
- Teprotumumab casesn = 13
- Teprotumumab controlsn = 18reference
- Tocilizumab casesn = 6
- Outcome
- Proptosis response (reduction ≥2 mm), resolution of diplopia, disease inactivation (clinical activity score (CAS) <3), reversion to mild disease severity
- Follow-up
- Week 24
Methodological detailsnational multicenter health system
- National multicenter health system
Main finding
As reported in the abstract
| Outcome | Teprotumumab cases | Tocilizumab cases |
|---|---|---|
| Proptosis response | 81% | 50% |
| Diplopia resolution | 45.5% | 16.7% |
| Disease inactivation | 85.7% | 100% |
| Mild disease severity | 58.3% | 75% |
Observational data: associations, not effects.
Further findings
Change between weeks 24 and 52
- Teprotumumab cases: trend toward worsening proptosis and diplopia
- Tocilizumab cases: trend toward worsening diplopia, disease activity and severity
Safety
- Teprotumumab subgroup: otic changes
- 46.2%
- Teprotumumab subgroup: hyperglycemia
- 23.1%
- Tocilizumab subgroup: reported adverse events
- 0
Original publication
Medical Therapy in Patients with Moderate to Severe, Steroid-Resistant, Thyroid Eye Disease. Thyroid. Published 23 August 2023. doi:10.
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