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Teprotumumab associated menstrual changes.

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Summary
This summary is machine-generated.

Teprotumumab treatment for thyroid eye disease (TED) caused menstrual changes, including amenorrhea, in 55% of patients. Most women experienced a return to normal menstruation after treatment, but awareness is crucial for providers.

Keywords:
IGF-1Thyroid eye diseaseamenorrheamenstruationteprotumumab

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Area of Science:

  • Endocrinology
  • Ophthalmology
  • Reproductive Health

Background:

  • Thyroid eye disease (TED) is an autoimmune condition affecting the orbits.
  • Teprotumumab is a novel biologic agent used for active TED treatment.
  • Menstrual cycle irregularities are a potential, underreported adverse effect of systemic therapies.

Purpose of the Study:

  • To determine the incidence and characteristics of menstrual cycle alterations in patients receiving teprotumumab for TED.
  • To document the types of menstrual changes and their temporal relationship to teprotumumab infusions.

Main Methods:

  • Retrospective chart review of 51 female patients treated with teprotumumab across three institutions (2020-2023).
  • Data collected included patient demographics, thyroid status, hormonal contraception use, and menstrual cycle data (type, onset, duration).
  • Clinical activity scores and adverse events were also recorded.

Main Results:

  • 55% of patients (28/51) experienced menstrual changes.
  • The most frequent changes were amenorrhea (75%) and oligomenorrhea (21%).
  • Menstrual irregularities occurred around 58 days after the first infusion, with a mean return to normal menstruation of 155 days post-treatment; 14% did not resume normal cycles by last follow-up.

Conclusions:

  • Menstrual cycle disturbances are a common adverse event associated with teprotumumab therapy in women with TED.
  • Amenorrhea and oligomenorrhea are the predominant changes observed.
  • Healthcare providers should counsel patients on the potential for menstrual irregularities during teprotumumab treatment.