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Patterns of Teprotumumab-Induced Hearing Dysfunction: A Systematic Review
Kevin Wong1, Priya Arya1, Yansy Salmeron1
1Department of Otorhinolaryngology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Summary
Teprotumumab treatment can cause hearing loss, primarily affecting higher frequencies. Further research is needed to understand the incidence and mechanisms of this ototoxicity.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Pharmacology
Background:
- Teprotumumab, a monoclonal antibody, is used to treat thyroid eye disease.
- Hearing loss has been anecdotally reported following teprotumumab administration.
Purpose of the Study:
- To systematically review existing evidence on the patterns of ototoxicity associated with teprotumumab treatment.
Main Methods:
- A systematic review of studies indexed in PubMed, EMBASE, and Cochrane Library was conducted.
- Included studies involved patients prescribed teprotumumab with pre- and posttreatment audiometric data.
- Exclusion criteria comprised non-English articles, case reports, reviews, and studies lacking audiometric data.
Main Results:
- Seven studies involving 109 patients were included, with evidence levels ranging from 2 to 4.
- The most frequent symptoms were hearing loss (22%), ear fullness (18%), and tinnitus (14%).
- Ototoxicity, defined by audiometric shifts, was observed in 41% of patients, predominantly in mid-to-high frequencies. Ultrahigh frequency testing revealed exclusive shifts in 53% of tested patients.
Conclusions:
- Teprotumumab treatment is associated with ototoxicity, manifesting as hearing loss in higher frequencies.
- Routine hearing screening, potentially including ultrahigh frequency audiometry, may be beneficial for patients.
- The precise incidence and mechanisms of teprotumumab-induced ototoxicity require further investigation.
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