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Teprotumumab-Associated Hyperglycemia: A Large-Scale Multinational Cohort Study.

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Thyroid : Official Journal of the American Thyroid Association
|April 9, 2026
PubMed
Summary
This summary is machine-generated.

Teprotumumab treatment for thyroid eye disease (TED) increases the risk of prediabetes and diabetes. Routine glucose monitoring is recommended for patients receiving this therapy.

Keywords:
Graves’ diseasehyperglycemiahyperthyroidismteprotumumabthyroid eye disease

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Area of Science:

  • Endocrinology
  • Ophthalmology
  • Pharmacology

Background:

  • Teprotumumab is the first FDA-approved treatment for thyroid eye disease (TED).
  • Hyperglycemia is a known adverse event, but real-world data on its incidence and impact are limited.

Purpose of the Study:

  • To evaluate the risk of glycemic abnormalities associated with teprotumumab treatment.
  • Utilized a large, multinational electronic health records database for analysis.

Main Methods:

  • Retrospective cohort study using the TriNetX Global Collaborative Network.
  • Propensity score matching (PSM) compared 792 teprotumumab-treated TED patients with 792 controls.
  • Assessed incident prediabetes, diabetes, hyperglycemia, and antidiabetes medication initiation over 5 years.

Main Results:

  • Teprotumumab significantly increased the risk of prediabetes (HR: 2.03) and diabetes (HR: 2.23) at 5 years.
  • 24% of treated patients developed prediabetes compared to 10% of controls.
  • Treated patients were more likely to require antidiabetes medications (HR: 1.68).

Conclusions:

  • Teprotumumab treatment is associated with an increased risk of dysglycemia in patients with TED.
  • The absolute increase in glycemic risk was modest.
  • Routine glucose monitoring and individualized risk-benefit assessment are crucial for teprotumumab therapy.