Efficacy and Safety of Teprotumumab in Thyroid Eye Disease

Teo, Honeylen Maryl Tiu; Smith, Terry J.; Joseph, Shannon S.

doi:10.2147/tcrm.s303057

Cited by 12 publications

(10 citation statements)

References 58 publications

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“…Patients undergoing treatment with the drug demonstrated lasting responses in proptosis, inflammation, diplopia, and QoL compared to placebo [ 8 , 9 , 17 ]. Additionally, when compared to other treatment modalities for TED (i.e., glucocorticoids, orbital radiotherapy, and other monoclonal antibodies), meta-analyses have demonstrated teprotumumab’s superiority in several of these measures [ 18 - 20 ].…”

Section: Discussionmentioning

confidence: 99%

Side Effects and Adverse Events After Treatment With Teprotumumab for Thyroid Eye Disease: A Retrospective Observational Case Series

Mukit,

Manley,

Patel

et al. 2024

Cureus

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As the use of teprotumumab for thyroid eye disease (TED) becomes more prolific, there remains a scarcity of literature regarding the associated side effects and adverse events of teprotumumab use. The authors present a single-center retrospective, observational case review of TED patients who received at least a single dose of teprotumumab infusion at the oculofacial plastic surgery service between February 2020 and July 2023. The most predominant recollected side effects were fatigue, brittle nails, dry eye symptoms, hair loss, muscle spasms, and dry mouth. Significant adverse events were limited to two cases of a blood clot and a single case of pulmonary embolism. This is the first retrospective study of patient-reported side effects and adverse events experienced by a cohort of teprotumumab users.

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Section: Discussionmentioning

confidence: 99%

Side Effects and Adverse Events After Treatment With Teprotumumab for Thyroid Eye Disease: A Retrospective Observational Case Series

Mukit,

Manley,

Patel

et al. 2024

Cureus

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“…Both studies reported a reduction in proptosis of greater than 2 mm, and at least a 2-point reduction in their Clinical Activity Score (CAS), as compared to the placebo group. Of note, while patient populations in the RCTs were limited to active moderate-to-severe TED, the drug was approved by the FDA without specific reference to the disease stage [ 38 ]. Teprotumumab is given intravenously, with patients receiving eight weight-based infusions every three weeks.…”

Section: Discussionmentioning

confidence: 99%

Refractory Thyroid Eye Disease Unresponsive to Teprotumumab: A Case Report

Singh,

Taylor,

Michalek

2023

Cureus

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Thyroid eye disease (TED) is a complex autoimmune condition that can cause proptosis, ophthalmoplegia, diplopia, optic nerve compression, and vision loss. These clinical findings are caused by a complex pathological mechanism characterized by thyroid-stimulating hormone receptor autoantibodies activating thyroid-stimulating hormone receptors (TSH-Rs). Overexpressed insulin-like growth factor 1 (IGF-1) receptors found in orbital fibroblasts form complexes with these TSH-Rs, leading to the inflammation and expansion of these tissues. Teprotumumab, a human monoclonal antibody sold under the brand name Tepezza, is currently the only FDA-approved immunotherapy for the treatment of TED. Given as an intravenous infusion every three weeks, teprotumumab works by suppressing IGF-1 receptors, thereby interfering with TSH-R and IGF-1 complex-mediated actions in these fibroblasts. The efficacy of teprotumumab was established in randomized, placebo-controlled clinical trials, which demonstrated clinically meaningful improvements in proptosis, inflammation, and diplopia. While teprotumumab has been shown to be efficacious, our patient with TSHRAb-positive euthyroid thyroid-associated ophthalmopathy who presented with diplopia did not have any significant improvement following the standard treatment dose of eight infusions over a 24-week period. This case underscores not only barriers to treatment, such as the high cost of teprotumumab but also highlights the importance of identifying risks for nonresponse.

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“…The Municipality is predominantly rural with only 20 and 6 communities classified as urban and peri-urban areas respectively. In the Tamale Metropolis, there are 116 communities with 60 being rural areas and 41 and 15 being urban and peri-urban areas respectively [ 28 ]. Agriculture is the main economic activity of the majority of the inhabitants of northern Ghana.…”

Section: Methodsmentioning

confidence: 99%

Exclusive breastfeeding among beneficiaries of a nutrition enhancement programme and its associated factors in Ghana

Adokiya,

Bukari,

Ndago

et al. 2023

PLoS ONE

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Introduction Despite the gains on exclusive breastfeeding (EBF), recent nationwide surveys have consistently revealed a decline in EBF rates in Ghana. The World Food Programme implemented an intervention for Enhanced Nutrition and Value Chain (ENVAC) which was based on three pillars including pregnant women, lactating women, adolescent and children under two years old being beneficiaries of the third pillar since the first 1000 days are critical for averting malnutrition. The social behavior change communication (SBCC) interventions implemented as part of this project have a potential to increase EBF among beneficiaries but this has not been measured. Therefore, this study assessed the prevalence of EBF practice among mothers with children under two years old who were beneficiaries of the ENVAC project and its associated factors in northern Ghana. Methods This was a cross-sectional study involving 339 mother-child pairs in two districts of the northern region of Ghana. Participants were mother-child pairs who benefitted from the ENVAC project, which used SBCC strategies to promote good feeding and care practices as well as address other causes of malnutrition during antenatal care and child welfare clinic services among pregnant women, lactating mothers, and children under two years. We used WHO standard questionnaire to assess breastfeeding practices. Factors associated with EBF were modelled using multivariable logistic regression. Results Exclusive breastfeeding was 74.6% (95%CI = 69.5% -79.2%) in the ENVAC project areas, a 31.7% points higher than recent national levels. Adjusted analyses showed that EBF practice was associated with increasing maternal education: moderately educated women [aOR = 4.1 (95% CI = 2.17–7.66), P<0.001], and high [aOR = 9.15, (95% CI = 3.3–25.36), P<0.001], and access to pipe-borne water in households [aOR = 2.87, (95% CI = 1.11–7.43), P = 0.029]. Conclusion A social behaviour change communication strategy implemented by ENVAC to lactating mothers likely improved exclusive breastfeeding practice in two districts of northern Ghana. EBF practices were higher among beneficiaries with high education and households with access to pipe-borne water. A combination of SBCC strategies and maternal and household factors are likely the best way to increase EBF rates in impoverished communities and warrants further investigation through future research.

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Efficacy and Safety of Teprotumumab in Thyroid Eye Disease

Cited by 12 publications

References 58 publications

Side Effects and Adverse Events After Treatment With Teprotumumab for Thyroid Eye Disease: A Retrospective Observational Case Series

Side Effects and Adverse Events After Treatment With Teprotumumab for Thyroid Eye Disease: A Retrospective Observational Case Series

Refractory Thyroid Eye Disease Unresponsive to Teprotumumab: A Case Report

Exclusive breastfeeding among beneficiaries of a nutrition enhancement programme and its associated factors in Ghana

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