Teprotumumab retreatment beneficial for TED patients with insufficient initial response

Patients with thyroid eye disease (TED) who do not respond to initial treatment with teprotumumab may benefit from additional teprotumumab therapy, according to a study. In addition, patients with long disease duration appear to have similar responses to patients treated earlier.

Patients from the randomized double-masked, multicenter, placebo-controlled OPTIC study who received placebo (n = 37) or who received teprotumumab (n = 14) were treated with teprotumumab in OPTIC-X.

In OPTIC-X, 89.2% of patients who received placebo in OPTIC became proptosis responders after treatment with teprotumumab, with an equivalent magnitude response to those in OPTIC. After 48 weeks, proptosis responses were maintained in 29 out of 32 (90.6%) responders, CAS 0 or 1 responses were maintained in 20 out of 21(95.2%) responders, and diplopia responses were maintained in 12 out of 14 (85.7%) responders. There was a median TED duration of 12.9 months in these patients compared with 6.3 months in patients treated with teprotumumab in OPTIC.

There were 5 patients that were teprotumumab non-responders in OPTIC that were retreated in OPTIC-X. After retreatment, 2 responded, 1 had a proptosis reduction of 1.5 mm from OPTIC baseline, and 2 stopped treatment early.

Approximately, 63% of OPTIC teprotumumab responders who flared became responders after retreatment.

Four mild hearing impairment events occurred during the first course of treatment and 2 events reoccurred following retreatment.

Reference
Douglas RS, Kahaly GJ, Ugradar S, et al. Teprotumumab Efficacy, Safety and Durability in Longer Duration Thyroid Eye Disease and Retreatment: Optic-X Study. Ophthalmol. 2021;S0161-6420(21)00818-6. doi: 10.1016/j.ophtha.2021.10.017. Epub ahead of print. PMID: 34688699.