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Patients with Thyroid Eye Disease Initiating Teprotumumab: A Real-World Cohort Study Using the Linked IRIS-Komodo
Louise A Mawn1, Erin Moore Shriver2, Madhura Tamhankar3
1Department of Ophthalmology, Vanderbilt University Medical Center, Vanderbilt Eye Institute, Nashville, TN, USA.
Purpose:
To describe patient characteristics and teprotumumab treatment patterns among patients with thyroid eye disease (TED), using large-scale, linked clinical and claims data.
Patients And Methods:
This was an observational, retrospective cohort study using linked data from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) and Komodo Health Research Dataset (KRD; 2019-2024). Adult (≥18 years) patients with a confirmed TED diagnosis in the IRIS Registry who initiated teprotumumab (ie, received ≥1 teprotumumab infusion in KRD) after its approval, and met continuous health plan enrollment requirements before and after treatment initiation were included. Outcomes were examined overall and stratified by TED duration at index (<24 months vs ≥24 months). Outcomes included demographics (eg, age, sex at birth, race) and baseline disease burden (eg, clinical activity score [CAS], intraocular pressure, proptosis, eye signs and symptoms), as well as teprotumumab infusion patterns.
Results:
A total of 2,886 patients were included (mean age: 59 years; 77% female). At baseline, 79% had ≥1 eye sign or symptom (proptosis: 45%; diplopia: 29%). Among 356 patients with CAS recorded, 91% had active disease (CAS ≥3/7 or 4/10). Teprotumumab was initiated within 12 months of TED diagnosis in 70% of patients. Among patients assessed for teprotumumab infusion patterns, 65% completed the 8-infusion course (median time to completion: 5 months); 35% discontinued (mean number of infusions received: 4); discontinuation peaked at the seventh infusion. Retreatment with teprotumumab occurred in 10% of patients completing the first course, 26% of whom completed the second course.
Conclusion:
This large real-world analysis reveals high baseline TED burden, teprotumumab adoption within one year of diagnosis, and adherence to FDA-indicated dosing. The findings reflect evolving clinical practice in TED management and support the need for ongoing research to assess how teprotumumab may influence the natural history of disease over time.
