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

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.