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Thyroid Eye Disease

Teprotumumab shows promise in treating dysthyroid optic neuropathy

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Teprotumumab has demonstrated significant effectiveness in treating dysthyroid optic neuropathy (DON) in patients with active thyroid eye disease (TED), according to a study.

The study, which reviewed 10 observational studies and case reports, supplemented by 2 cases from the authors’ clinical practice, found that teprotumumab led to substantial improvements in visual acuity, color vision, visual fields, proptosis, and clinical activity scores.

Altogether, 24 active TED patients with DON (affecting 37 eyes) were treated with teprotumumab. Disease duration ranged from 2 months to over 15 years. Notably, 22 out of 24 patients had experienced limited improvement or progression of visual loss with prior treatments including corticosteroids, orbital decompression, and orbital radiation.

Of the patients, 88% reported enhanced visual acuity following teprotumumab treatment, with 75% experiencing improvements after 2 infusions. Decompression surgery near teprotumumab infusions was excluded from the analysis. Visual acuity improved by an average of 3.73 lines, ranging from 2 to 15 lines across 33 eyes. Additionally, the mean improvement in the mean deviation on visual field testing was 5.6 dB. Proptosis saw an average improvement of 4.37 mm, and the clinical activity score exhibited a mean reduction of 5.1.

Reference
Tamhankar MA, Pradeep T, Chen Y, Briceño CA. Real-World Experience With Teprotumumab in Patients With Dysthyroid Optic Neuropathy. J Neuroophthalmol. 2023;doi: 10.1097/WNO.0000000000001994. Epub ahead of print. PMID: 37751310.

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