泰波图马布用于治疗反复性甲状腺眼病的治疗
Clara J Men1, Linus Amarikwa1, Brandon Pham2
1Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, U.S.A.
Ophthalmic plastic and reconstructive surgery
|November 16, 2023
概括
德鲁马布有效治疗反复性甲状腺眼病 (TED),改善proptosis,diplopia和临床活动得分. 这种类似胰岛素的生长因子1受体单克隆抗体为那些没有对先前疗法的反应的患者提供了有价值的选择.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 甲状腺眼部疾病 (TED) 是一种影响轨道的自身免疫性疾病.
- 作为一种类似胰岛素的生长因子1受体 (IGF-1R) 单克隆抗体的teprotumumab被FDA批准用于中度至重度的TED.
- 关键试验排除了先前接受过放射治疗,手术或生物治疗的患者,限制了对反抗病例的数据.
研究的目的:
- 为了评估teprotumumab在患有重复性甲状腺眼病的患者中的疗效.
- 评估患者的治疗结果,这些患者在TED的传统治疗中失败了.
主要方法:
- 在66名中度至重度TED患者的多中心回顾性研究中,这些患者之前的治疗都失败了.
- 包括接受至少4次teprotumumab输注的患者.
- 主要结局:减少质,减少临床活性评分 (CAS) 和改善双眼视.
主要成果:
- 观察到高响应率:85.9%的proptosis, 93.8%的CAS,和69.1%的双眼视.
- 平均降低了3.1毫米的proptosis和3.8点的CAS改进.
- 之前的轨道减压手术与较差的双眼视和死反应有关 (p=0.014,p=0.045).
- 四名患者报告了持续性听力损失的严重不良事件.
结论:
- 德鲁马布在反抗性TED患者中表现出显著的疗效,与以前没有接受过治疗的患者相比.
- 对于那些对先前的医疗疗法不耐药的患者来说,这是一个可行的治疗选择.
- 由于潜在的反应减弱,建议对之前有轨道减压的患者进行谨慎.
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