- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Use of Steroids Pre- and Post-Teprotumumab in Thyroid Eye Disease Patients () - Jul 16, 2022 - Abstract #ENDO2022ENDO_2355;
After teprotumumab therapy, the number of patients receiving steroids was reduced by more than 70%, and the median total dose of steroids per patient decreased by more than 80% from pre-teprotumumab doses. These results indicate that teprotumumab therapy is associated with reduced steroid use in TED patients.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Teprotumumab Reduces Orbital Fat And Muscle Volume In Patients With Thyroid Eye Disease () - Jul 16, 2022 - Abstract #ENDO2022ENDO_2219;
Following therapy, we found that both, muscle and fat reduced significantly in all patients. Therefore, the proptosis reducing properties of teprotumumab are related to a reduction in muscle and fat volume behind the eye, in patients with TED.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Efficacy of Teprotumumab for Thyroid Eye Disease in Hypothyroid Patients () - Jul 16, 2022 - Abstract #ENDO2022ENDO_1477;
Compared to patients with low thyroid levels receiving placebo (no therapy), these teprotumumab-treated hypothyroid patients had more improvements in their TED symptoms. These responses were similar to the improvements seen in the overall teprotumumab-treated population in these trials.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Blood Glucose in Thyroid Eye Disease (TED) in Patients treated with Teprotumumab: Clinical Trials Data () - Jul 16, 2022 - Abstract #ENDO2022ENDO_1230;
Most of these reports occurred in patients with pre-existing diabetes or pre-diabetes, and most cases were easily resolved with medication. This assessment identified no severe blood sugar increase or increased risk for development of diabetes with teprotumumab, but it is recommended that blood sugar be monitored in all patients and to treat hyperglycemia with glycemic control medications.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Echographic Assessment of Extraocular Muscle Response to Teprotumumab. (Pubmed Central) - Jul 13, 2022
Orbital echography demonstrated extraocular muscle reduction in all patients after teprotumumab, correlating with improved clinical activity score, ocular motility, and proptosis. Orbital echography is a safe and cost-effective imaging alternative to monitor therapeutic response to teprotumumab.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Ototoxicity and Teprotumumab. (Pubmed Central) - Jul 8, 2022
This is one of the first descriptive cases of ototoxicity resulting in irreversible sensorineural hearing loss in the setting of treatment with teprotumumab. Periodic audiologic evaluations should be recommended to patients on teprotumumab.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Update on thyroid eye disease: Regional variations in prevalence, diagnosis, and management. (Pubmed Central) - Jul 7, 2022
Most recently, targeted therapies such as teprotumumab, an insulin-like growth factor-1 receptor antagonist, have been studied in the context of TED, with promising initial data. In this review, updates in the understanding and management of TED are presented with a focus on the international variations in presentation and management.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
246 - Controversies in Neuro-Ophthalmic Management (S505AB) - Jul 2, 2022 - Abstract #AAO2022AAO_168;
Topics will include Graves ophthalmopathy, skull base cerebrospinal fluid leak in pseudotumor cerebri, optic neuritis and transient monocular vision loss. Objectives At the conclusion of this course, the attendee will be able to discuss (1) management of Graves optic neuropathy and Graves ophthalmopathy that flares after teprotumumab treatment, (2) indications for lumbar puncture and acetazolamide treatment in the setting of cerebrospinal fluid leak, (3) recommendations for timing and mode of administration of steroids and indications for plasmapheresis in the setting of optic neuritis and (4) approach to characterization of transient monocular vision loss.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Teprotumumab for thyroid eye disease: early response is not required for benefit. (Pubmed Central) - Jun 29, 2022
Objectives At the conclusion of this course, the attendee will be able to discuss (1) management of Graves optic neuropathy and Graves ophthalmopathy that flares after teprotumumab treatment, (2) indications for lumbar puncture and acetazolamide treatment in the setting of cerebrospinal fluid leak, (3) recommendations for timing and mode of administration of steroids and indications for plasmapheresis in the setting of optic neuritis and (4) approach to characterization of transient monocular vision loss. There is variability in the time taken to manifest a clinically significant response to teprotumumab, some patients my need a longer time to respond.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Google Searches for Thyroid Eye Disease After Regulatory Approval of Teprotumumab. (Pubmed Central) - Jun 22, 2022
Google Trends may serve as a useful tool for measuring the influence of pharmaceutical advertising campaigns on information-seeking behavior in the public. Additional studies are warranted to determine how these changes in public interest correlate with clinical measures, such as referral patterns.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Advances in the Treatment of Thyroid Eye Disease Associated Extraocular Muscle Myopathy and Optic Neuropathy. (Pubmed Central) - Jun 11, 2022
New targeted therapies have the potential to reduce the extraocular muscle and orbital volume expansion which can lead to diplopia and vision loss from optic nerve compression. Longer term efficacy and durability data is needed to determine the role biologics, such as teprotumumab, should play in the treatment of TED patients compared to the current standard of care.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Thinking inside the box: Current insights into targeting orbital tissue remodeling and inflammation in thyroid eye disease. (Pubmed Central) - May 29, 2022
A major breakthrough in TED therapy occurred with the FDA approval of teprotumumab, a monoclonal insulin-like growth factor 1 receptor (IGF1R) blocking antibody...We describe approaches to target orbital fibroblasts and the complex pathophysiology that underlies tissue remodeling and inflammation driving TED. Further advances in the elucidation of the mechanisms of TED may lead to prophylaxis based upon early biomarkers as well as lead to more convenient, less expensive therapies.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Improvement of asymmetric thyroid eye disease with teprotumumab. (Pubmed Central) - May 26, 2022
P2, P3
Further advances in the elucidation of the mechanisms of TED may lead to prophylaxis based upon early biomarkers as well as lead to more convenient, less expensive therapies. The findings in this study suggest the differential impact of teprotumumab on orbits that are clinically more affected by TED, suggesting that teprotumumab reduces asymmetry.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Visual Recovery of Dysthyroid Optic Neuropathy With Teprotumumab. (Pubmed Central) - May 26, 2022
The findings in this study suggest the differential impact of teprotumumab on orbits that are clinically more affected by TED, suggesting that teprotumumab reduces asymmetry. No abstract available
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Bilateral dysthyroid compressive optic neuropathy responsive to teprotumumab. (Pubmed Central) - May 19, 2022
Teprotumumab is an IGF-IR inhibitor recently FDA-approved for active thyroid eye disease. The authors report reversal of bilateral dysthyroid compressive optic neuropathy managed medically utilizing teprotumumab.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
BOPSS Highlights (Boisdale) - May 16, 2022 - Abstract #RCOphth2022RCOphth_386;
Jonathan Roos, London 5.Clinical characteristics of infiltrative periocular basal cell carcinoma. Aaron Jamison, Gartnavel General Hospital
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
The Effect of Teprotumumab on Ocular Surface Symptoms in Thyroid Eye Disease (A0339) - Apr 29, 2022 - Abstract #ARVO2022ARVO_2291;
Teprotumumab was effective in significantly mitigating clinical ocular surface symptoms, although the effect on objective physical exam findings was negligible. Given the complexity of dry eye syndrome and the importance of the subjective experience of disease, our findings illustrate a possible benefit of this therapy.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Teprotumumab-related hearing loss treated with oral corticosteroids (A0347) - Apr 29, 2022 - Abstract #ARVO2022ARVO_2290;
Effective management of teprotumumab-related hearing loss should include risk factor assessment, patient education, baseline audiometric testing, early identification of hearing symptoms with repeat audiogram testing. If hearing loss is detected, prompt oral prednisone burst therapy should be considered.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Long-term real world teprotumumab outcomes (A0346) - Apr 29, 2022 - Abstract #ARVO2022ARVO_2288;
Although regression of the initially robust proptosis response may occur, most patients do not develop reactivation of active TED. Further investigation on the long-term durability of proptosis response and reason for proptosis regression in a portion of patients is warranted.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Comparison of treatment cost and quality-of-life impact of thyroid eye disease therapies ([Virtual]) - Apr 29, 2022 - Abstract #ARVO2022ARVO_2286;
Long-term data regarding the effect of teprotumumab on reducing the rates of orbital and strabismus surgery and improving ocular sequelae, as well as studies evaluating the impact of treatment on QoL using quality-adjusted life years, are needed to be able to determine the cost-effectiveness of the various treatment options for TED. Images: Table 1.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Clinical, Retrospective data, Journal: Proptosis and Diplopia Response With Teprotumumab and Placebo vs the Recommended Treatment Regimen With Intravenous Methylprednisolone in Moderate to Severe Thyroid Eye Disease: A Meta-analysis and Matching-Adjusted Indirect Comparison. (Pubmed Central) - Apr 26, 2022
This meta-analysis suggests that use of IVMP is associated with a small, typically not clinically relevant, change from baseline in proptosis vs placebo, with modest changes in diplopia. While this nonrandomized comparison suggests that use of teprotumumab, compared with IVMP, is associated with greater improvements in proptosis and may be twice as likely to have a 1 grade or higher reduction in diplopia, randomized trials comparing these 2 treatments would be warranted to determine if 1 treatment is superior to the other to a clinically relevant degree.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: New Therapeutic Horizon of Graves' Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine. (Pubmed Central) - Apr 26, 2022
The clinical demand for new therapeutic regimens, coupled with a deeper understanding of the pathophysiology and immunobiology of Graves' disease, has led to the emergence of several new therapeutic ideas, including biologics, small molecule peptides, immunomodulators and teprotumumab, a specific antibody targeting IGF-1R...Based on the pathophysiology and efficacy of clinical management and treatment in Graves' hyperthyroidism, here we review the new strategies under investigation and summarize the effective components of traditional Chinese medicine used for Graves' hyperthyroidism, and explore their mechanisms. These therapies have opened a new window for the treatment of Graves' disease, but the exact mechanism and the research direction still need to be further explored.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Teprotumumab reduces extraocular muscle and orbital fat volume in thyroid eye disease. (Pubmed Central) - Apr 23, 2022
P3
These therapies have opened a new window for the treatment of Graves' disease, but the exact mechanism and the research direction still need to be further explored. Orbital imaging demonstrated decreased EOM volumes and orbital fat tissue volumes after teprotumumab treatment.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Clinical, Journal: Rifle Blast Exacerbating Hearing Loss in a Patient Treated With Teprotumumab for Thyroid Eye Disease. (Pubmed Central) - Apr 22, 2022
In this case, it is suspected the teprotumumab infusions resulted in increased susceptibility of the inner ear hair cells to noise-induced trauma secondary to IGF-IR inhibition. Specific ear protection protocols may need to be implemented in the future for patients on teprotumumab therapy to prevent sustained hearing loss, especially for susceptible patient populations.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Teprotumumab-associated chronic hearing loss screening and proposed treatments. (Pubmed Central) - Apr 21, 2022
Teprotumumab was immediately stopped, however repeat audiogram 6 weeks later showed no improvement. Given potentially irreversible sensorineural hearing loss, we recommend close monitoring with regular audiometric testing before, during and after teprotumumab therapy and propose potential treatment to reverse its effects in the ear.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Inhibition of TSH/IGF-1 receptor crosstalk by Teprotumumab as a treatment modality of Thyroid Eye Disease. (Pubmed Central) - Apr 19, 2022
Given potentially irreversible sensorineural hearing loss, we recommend close monitoring with regular audiometric testing before, during and after teprotumumab therapy and propose potential treatment to reverse its effects in the ear. We conclude that Tepro inhibits HA production by TEDOFs by inhibiting TSHR/IGF1R crosstalk and suggest that inhibition of TSHR/IGF1R crosstalk is the mechanism of its action in treating TED.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Mechanisms in Graves Eye Disease: APOPTOSIS AS THE END POINT OF IGF-1 RECEPTOR INHIBITION. (Pubmed Central) - Apr 19, 2022
In contrast, an IGF-1R-B-mAb was capable of suppressing IGF-1R signaling leading to retro-orbital fibroblast/adipocyte death via the cell-extrinsic pathway of apoptosis. This is likely the major mechanism involved in proptosis reduction in patients with Graves' eye disease treated by IGF-1R inhibition.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Clinical, Journal: Sensorineural Hearing Loss After Teprotumumab Therapy for Thyroid Eye Disease: A Case Report. (Pubmed Central) - Apr 12, 2022
There are currently no formal guidelines for routine audiograms before, during, and after infusion of teprotumumab. Given that such guidelines exist for ototoxic medications such as gentamicin and cisplatin, we strongly encourage audiometric monitoring for patients undergoing treatment with teprotumumab.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Thyroid eye disease: From pathogenesis to targeted therapies. (Pubmed Central) - Apr 12, 2022
The emergence of novel biologics resulted in a paradigm shift in the treatment of TED. We here review the literature on advances of pathogenesis of TED and promising therapeutic targets and drugs.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Insights into Current Management Strategies for Dysthyroid Optic Neuropathy: A Review. (Pubmed Central) - Mar 26, 2022
The early introduction and combination of these immunomodulators, including Janus kinase inhibitors and insulin-like growth factor-1 receptor antibody (teprotumumab), may be effective for GO with DON...It is possible that these options could reduce systemic adverse events due to unfocused glucocorticoid administration. The pathophysiology of DON is not yet fully understood, and further studies of its treatment and long-term visual function prognosis are needed.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Journal: Thyroid dermopathy responds to teprotumumab therapy. (Pubmed Central) - Mar 24, 2022
Teprotumumab is a Food and Drug Administration-approved medication used for thyroid eye disease (TED). Our patients treated with teprotumumab for TED showed improvement of TD, which demonstrates its potential use for this condition.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Clinical, Journal: Teprotumumab in Clinical Practice: Recommendations and Considerations From the OPTIC Trial Investigators. (Pubmed Central) - Mar 19, 2022
Confirming the efficacy of teprotumumab usage outside the narrow parameters of the completed clinical trials will require rigorous scientific validation. As a step in that direction, we believe its on-label usage is appropriately applied to all patients with TED with substantial symptoms or morbidity, as judged by their physician.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Review, Journal: Medical and Surgical Treatment of Thyroid Eye Disease. (Pubmed Central) - Mar 18, 2022
Inactive but moderate to severe disease may be treated by orbital decompression, strabismus and eyelid surgery. Systematic assessment and management by both an endocrinologist and ophthalmologist to achieve and maintain euthyroidism and select and sequence treatments according to activity and severity of TED gives the best results for quality of life and vision.
- |||||||||| Tepezza (teprotumumab) / Horizon Therapeutics, Roche
Clinical, Review, Journal: 2021 update on thyroid-associated ophthalmopathy. (Pubmed Central) - Mar 16, 2022
Systematic assessment and management by both an endocrinologist and ophthalmologist to achieve and maintain euthyroidism and select and sequence treatments according to activity and severity of TED gives the best results for quality of life and vision. The past decade has been filled with substantial scientific advances that should provide the necessary springboard for continually accelerating discovery over the next 10 years and beyond.
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