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Early experience with teprotumumab for chronic thyroid eye disease
Daniel J Ozzello1, Don O Kikkawa1,2, Bobby S Korn1,2
1Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Viterbi Family Department of Ophthalmology, La Jolla, CA, USA.
American Journal of Ophthalmology Case Reports
|May 29, 2020
Summary
Teprotumumab effectively treated chronic thyroid eye disease (TED) in a patient with inactive Graves' disease. The treatment reduced proptosis and extraocular muscle volume, suggesting potential for quiescent TED.
Area of Science:
- Ophthalmology
- Endocrinology
- Immunology
Background:
- Thyroid eye disease (TED) is an autoimmune condition often associated with Graves' disease.
- Chronic TED typically presents with stable proptosis and minimal inflammatory signs.
- Current treatment options for inactive TED are limited.
Observation:
- A 50-year-old female with a 3-year history of Graves' disease and chronic TED was treated with teprotumumab.
- Despite a low clinical activity score (CAS) and stable proptosis, the patient received systemic teprotumumab therapy.
- Orbital imaging and measurements were used to assess treatment response.
Findings:
- Teprotumumab treatment resulted in significant improvement in proptosis (from 23mm OD, 28mm OS to 18mm OD, 22mm OS).
- A notable decrease in extraocular muscle volume was observed on orbital imaging.
- The patient experienced improvement despite having chronic TED and a low CAS.
Implications:
- This case suggests teprotumumab may be a viable treatment option for chronic, inactive thyroid eye disease.
- Teprotumumab might alter the disease course even in patients with quiescent TED.
- Further research is warranted to explore teprotumumab's efficacy in inactive TED populations.
