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Oculoplastics

Teprotumumab is a ‘powerful resource’ for ophthalmologists treating TED

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During a presentation at AAO Subspecialty Day 2021, Suzanne K. Freitag, MD, Director of the Ophthalmic Plastic Surgery Service at Massachusetts Eye and Ear discussed the impact teprotumumab has had on her practice since it was approved in January 2020 by the FDA. Teprotumumab is the only approved therapy for the treatment of thyroid eye disease (TED).

Dr Freitag called teprotumumab a powerful resource for treating patients with TED.

“We used to tell patients with moderate and severe TED to expect not to look the same again… and I think for many patients, this is no longer true,” she said.

Dr Freitag said she has treated more than 100 patients with teprotumumab and manages the drug herself without an endocrinologist or rheumatologist. Logistical difficulties of utilizing teprotumumab include the cost, need for insurance authorization, and arrangement of infusions. Dr Freitag also mentioned that although it is not contradicted in people with diabetes, she uses caution in these patients.

Prior to the first dose, Dr Freitag does baseline serum glucose, HgB-A1C, and audiology testing and before each infusion, patients undergo a finger-stick glucose test and pregnancy test, where applicable.

In her experience, very few patients are non-responders, and treatment is rapidly effective in acute TED as well as reversing compressive optic neuropathy.

Amongst her patients, adverse reactions to teprotumumab were manageable, with 96% feeling they were mild or tolerable. Muscle spasms (55%), ear/hearing changes (36%), fatigue (30%), and nausea (25%) were the most reported.

Reference
Freitag SK. How Teprotumumab Fits Into My Practice. Presented at: AAO 2021.