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Observational Characterization of the Retreatment Course of Patients With Thyroid Eye Disease.

J Neuroophthalmol

January 2025

Scheie Eye Institute (YC, TL, SW, TP, PAA, G-sY, CAB, MAT), University of Pennsylvania, Philadelphia, Pennsylvania; Divisions of Neuro-ophthalmology (MAT), Oculoplastics (CAB), and Biostatistics (PAA, G-sY), Kansas Health Science Center, Kansas College of Osteopathic Medicine; and Kansas Health Science Center (GM), Kansas College of Osteopathic Medicine, Kansas, Missouri.

Background: To characterize the retreatment course of patients with thyroid eye disease (TED), who had reactivation after initial therapy with teprotumumab.

Methods: This was a single-center longitudinal cohort study of patients who received an initial course of teprotumumab for active TED and were followed for at least 6 months. Reactivation was defined as the increase of proptosis of 2 mm or more or an increase in Clinical Activity Score (CAS) of two points or more, as adapted from the Optic-X study.

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Background: The insulin-like growth factor 1 receptor (IGF-1R) and the thyrotropin receptor (TSH-R) are expressed on orbital cells and thyrocytes. These receptors are targeted in autoimmune-induced thyroid eye disease (TED). Effective therapeutic treatment of TED inhibits activation of the IGF-1R/TSH-R complex.

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Purpose: Teprotumumab, a novel human monoclonal antibody, has been shown to reverse the clinical manifestations of thyroid eye disease. Previous reports have suggested that it demonstrates disease-modifying properties through the reduction of orbital fat and muscle volumes. This study aims to analyze orbital volumetric change following treatment and to identify clinical and radiological predictors of response.

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