NANOS 2023: Teprotumumab-trbw proves effective in treating patients diagnosed with dysthyroid optic neuropathy

The North American Neuro-Ophthalmology Society Annual Meeting is being held through March 16 in Orlando, Florida. (Adobe Stock image)

Horizon Therapeutics plc today announced results of an analysis of real-world treatment with teprotumumab-trbw (Tepezza, Horizon Therapeutics) in Thyroid Eye Disease (TED) patients with dysthyroid optic neuropathy (DON), the majority of whom had not previously responded to other treatments.

DON is a complication of TED characterized by thyroid-related impairment of visual function and can lead to permanent sight loss related to optic nerve compression.¹ Teprotumumab-trbw is the first and only medicine approved by the FDA for the treatment of TED – a serious, progressive and potentially vision-threatening rare autoimmune disease.^2,3

According to the company, this analysis summarizes real-world experience of people living with TED and DON who were treated with teprotumumab-trbw between January 2020 and September 2022. During this period, 24 patients were identified from literature and the author’s clinical experience with most (22 out of 24) receiving treatment with oral or intravenous steroids, surgery and/or radiation prior to teprotumumab-trbw.

In a news release, the company noted after teprotumumab-trbw treatment, meaningful improvement was observed in visual acuity in eyes with DON (mean lines of improvement of 3.7 – 23 patients, range 1-15, mean improvement in the mean deviation on visual field testing of -5.87 – 7 patients); proptosis (mean reduction of 4.4 mm – 19 patients); diplopia (mean improvement of 0.75 grade – 8 patients); and Clinical Activity Score (CAS) (mean reduction of 5.1 – 17 patients).

Reported adverse events were consistent with teprotumumab-trbw clinical trials and included fatigue, dysgeusia, hearing issues, nausea, hyperglycemia and muscle spasms.

Madhura A. Tamhankar, MD, study author and associate professor of ophthalmology and neurology at the Hospital of the University of Pennsylvania, pointed out in the news release that physicians know how devastating Thyroid Eye Disease can be for patients, and the risk of blindness in those with dysthyroid optic neuropathy is one of the most worrisome complications, especially when traditional therapies fail.

“These data are encouraging for physicians looking for an option to treat patients at the highest risk of losing their sight and provide evidence that Tepezza can help improve symptoms and preserve visual acuity,” Tamhankar said in the release.

Moreover, a recent health state analysis in JAMA Ophthalmology assessed the burden of TED, revealing people with moderate-to-severe disease experience substantial disutility in their day-to-day lives. In the study of over 100 general population participants, the worst impact on quality of life was associated with the most severe disease state (constant diplopia and large proptosis).⁴

“The spectrum and severity of Thyroid Eye Disease symptoms can vary greatly for people and often require significant intervention to avoid long-term repercussions and negative impact to everyday activity, especially when dysthyroid optic neuropathy is involved,” Mandeep Kaur, MD, MS, senior vice president, global medical affairs and outcomes research at Horizon, concluded in the news release. “This research underscores our ongoing commitment to ensuring patients receive appropriate care that can result in improved clinical outcomes.”

References

1. Agarwal A, et al. Dysthyroid Optic Neuropathy. StatPearls. 2022.

2. TEPEZZA (teprotumumab-trbw) [prescribing information] Horizon.

3. Barrio-Barrio J, et al. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. Journal of Ophthalmopathy. 2015;2015:249125.

4. Smith TJ, Cockerham K, Lelli G, et al. Utility Assessment of Moderate to Severe Thyroid Eye Disease Health States. JAMA Ophthalmol. Published online December 29, 2022. doi:10.1001/jamaophthalmol.2022.3225