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Thyroid Eye Disease

Presentation talks prevalence of hearing-related issues in TED patients treated with teprotumumab

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There is a lack of independent data on the prevalence of hearing-related issues in thyroid eye disease (TED) patients and those receiving teprotumumab.

To estimate the background rates of hearing-related changes, a study was conducted using deidentified closed claims data from the KOMODO database, cohorts of patients with Graves’ disease (GD), patients with TED, and patients receiving teprotumumab for GD. Patients were observed for at least 1 year prior to their TED/GD diagnosis or first teprotumumab infusion and 6 months post-diagnosis/infusion.

The analysis identified a total of 469,720 GD patients, 38,566 TED patients, and 967 patients receiving teprotumumab. A significant proportion of both GD and TED patients had hearing-related codes in their claims data. Among GD patients, 113,268 (24%) had hearing codes, with 62,526 (13%) indicating hearing loss/ototoxicity and 67,248 (14%) pertaining to hearing screening. Among TED patients, 12,807 (33%) had hearing codes, with 7662 (20%) indicating hearing loss/ototoxicity and 8033 (21%) pertaining to hearing screening. An increase in hearing-related codes and screening codes was observed around the time of GD/TED diagnosis.

The most frequently reported code among both GD and TED patients with hearing codes was “sensorineural hearing loss, bilateral” (SNHL), accounting for 29% of GD patients (32,961 out of 113,268) and 33% of TED patients (4279 out of 12,807) with hearing-related claims. Of the 967 patients receiving teprotumumab, 308 (32%) had hearing codes, with 172 (18%) indicating hearing loss/ototoxicity and 198 (20%) pertaining to hearing screening.

Notably, 210 out of the 308 patients (68%) had pre-existing hearing codes before their first teprotumumab infusion, while 98 patients (32%) developed new hearing codes afterward. SNHL was once again the most frequently reported code, affecting 34% of teprotumumab patients (104 out of 308) with hearing-related claims.

These findings align with previous studies indicating a decreased hearing ability, particularly at high frequencies, in GD patients, with mild-moderate SNHL observed in 23.5% of cases.

The study observed a similar rate of hearing-related claims in TED patients with GD, and SNHL was the most frequently reported hearing code across all cohorts.

Smith TJ, et al. Hearing-related Issues Associated with Graves’ Disease, Thyroid Eye Disease and Treatment with Teprotumumab. Presented at: ENDO 2023.