The Use of Biologics for Thyroid Eye Disease

Thyroid eye disease (TED) is the most common extrathyroidal manifestation of Graves' disease. It is an autoimmune disorder that may present with signs of inflammation and extracellular matrix modification, leading to the characteristic features of swelling within the orbit, proptosis, diplopia, and vision loss. Recently, a growing body of work has focused on novel therapies for the treatment of TED. We review novel therapeutic agents aimed at treating TED. A review of the literature was performed through search of PubMed, Scopus, and Web of Science databases for terms related to the treatment of TED. There are multiple therapeutic agents available for the treatment of TED, focusing on the different molecular pathways that are dysregulated in the pathogenesis of the condition. Therapeutic targets include: B cells (rituximab), cytokines (interleukin [IL]-6] and IL-11), insulin-like growth factor 1 receptor, and antibodies (neonatal fragment crystallizable receptor). Currently, clinical evidence supports the use of anti-insulin-like growth factor 1 receptor therapy. However, research involving anti-IL-11, anti-IL-6, and the neonatal fragment crystallizable receptor is promising.