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Teprotumumab-Related Hyperglycemia.
Linus Amarikwa1, Abubakr Mohamed2, Sun H Kim2,3
1Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
The Journal of Clinical Endocrinology and Metabolism
|October 27, 2022
Summary
Teprotumumab treatment for Graves orbitopathy can cause hyperglycemia, particularly in patients with diabetes. Careful monitoring and management guidelines are crucial for this adverse event.
Area of Science:
- Endocrinology
- Ophthalmology
- Immunology
Background:
- Graves orbitopathy (GO) is an autoimmune condition affecting the eyes.
- Teprotumumab, a monoclonal antibody, treats GO but can cause hyperglycemia.
- Hyperglycemia affects approximately 10% of patients in clinical trials.
Purpose of the Study:
- To determine the incidence, severity, and management of hyperglycemia in patients receiving teprotumumab.
- To analyze longitudinal glycemic changes during teprotumumab treatment in an academic cohort.
Main Methods:
- Observational study of patients treated with teprotumumab from March 2020 to May 2022.
- Regular monitoring of Hemoglobin A1c (HbA1c) every 3 months.
- Analysis of glycemic changes, risk factors, and outcomes in patients with varying baseline glucose levels.
Main Results:
- 52% of patients developed hyperglycemia, with most cases being mild to moderate.
- HbA1c increased significantly in patients with diabetes and prediabetes at 3 months.
- Age, pre-existing diabetes, and certain ethnicities were risk factors for hyperglycemia.
Conclusions:
- Teprotumumab poses a significant hyperglycemia risk, especially for diabetic patients.
- Hyperglycemia may persist even after treatment cessation.
- Guidelines for screening and managing teprotumumab-induced hyperglycemia are essential.
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