Teprotumumab for treating active thyroid eye disease: A meta-analysis

Thyroid eye disease (TED) is a disabling, organ-specific autoimmune disease that is a global health concern. Recently, certain biological agents have demonstrated unique advantages for the treatment of TED. Teprotumumab is an emerging biological agent used for TED treatment. This study assessed whether teprotumumab can serve as an effective and safe treatment for active TED through a meta-analysis of the literature.

We searched 4 databases (PubMed, The Cochrane Library, Web of Science, and Embase) for randomized controlled trials regarding the treatment of Graves' ophthalmopathy by teprotumumab by March 31, 2024. We screened the literature library and extracted the data according to the inclusion and exclusion criteria.

Our study included 5 articles that involved 411 cases. Significant differences were reported in the change from baseline in proptosis (proptosis vs baseline), diplopia response at week 24, and clinical activity score of 0 or 1 at week 24 in the teprotumumab versus placebo group. The teprotumumab group reported no significant risk of adverse events or serious adverse events during the intervention.

Teprotumumab significantly decreased proptosis and clinical activity score and improved diplopia response in patients with TED, with fewer adverse effects. Therefore, it is a promising biological agent. However, this conclusion should be further validated by high-quality, long-term randomized controlled trials with large sample sizes.