Teprotumumab may reduce need for orbital decompression in thyroid eye disease

Key takeaways:

• Patients treated with teprotumumab may be less likely to need orbital decompression.
• Exophthalmometry measurements were higher in orbits that underwent surgery vs. those that did not.

A decrease in the number of orbital decompression surgeries in patients with thyroid eye disease may be attributed to the introduction of teprotumumab treatment, according to a study published in Canadian Journal of Ophthalmology.

“Awareness of TED and newer treatments have had measurable impact on patients seeking treatment,” study co-author Don O. Kikkawa, MD, FACS, of Shiley Eye Institute at UC San Diego Health, told Healio. “In our center, treatment with teprotumumab reduced the overall need to perform orbital decompression in TED patients.”

The retrospective chart review evaluated 128 orbits of 64 patients with moderate to severe thyroid eye disease (TED) who were treated with Tepezza (teprotumumab-trbw, Amgen) at a single tertiary care center. Kikkawa and colleagues used the Epic SlicerDicer tool to assess trends in TED at the institution, which showed an increase in the number of patients with the disease since 2018 but a decrease in the number of decompression surgeries since 2020, when teprotumumab was approved.

Overall, 25% of patients and 18% of orbits underwent bony decompression after treatment with teprotumumab. Exophthalmometry measurements in orbits that underwent decompression were higher before (22.6 ± 3 mm) and after (19.9 ± 2.6 mm) treatment with teprotumumab vs. before (20.6 mm ± 3.2 mm) and after (18.5 ± 3 mm) treatment in those that did not require surgery (P = .001 and P = .016, respectively).

The average time to surgery after stopping treatment with teprotumumab was 12.6 ± 9.4 months, according to the study.

“Although some patients still underwent orbital decompression, treatment with teprotumumab provides an additional treatment option for TED patients desiring nonsurgical options for proptosis reduction,” Kikkawa said.

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Sources/Disclosures

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Disclosures:
Kikkawa reports consulting for Horizon Therapeutics (now Amgen), Immunovant and Thyroscope. Please see the study for all other authors’ relevant financial disclosures.

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