Teprotumumab may be effective in thyroid eye disease with less inflammation
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NEW ORLEANS — Teprotumumab may offer comparable proptosis efficacy in patients with thyroid eye disease with low levels of inflammation as seen in patients with higher levels of inflammatory activity, according to a study.
“Now we have the opportunity in a placebo-controlled trial to take those placebo patients that have been receiving saline for a period of time and then give them teprotumumab as a crossover called OPTIC-X,” Raymond S. Douglas, MD, PhD, said during a presentation at the American Academy of Ophthalmology meeting. “Then [we] can analyze what is going on and whether their characteristics are different and whether any of those characteristics affect the treatment outcome.”
Douglas and colleagues looked at patients who were enrolled in the placebo arm of the OPTIC randomized controlled trial and had persistent proptosis at the end of study. The patients were enrolled in the OPTIC-X trial and received eight teprotumumab infusions over 24 weeks.
The study included 15 patients (average age, 47.2 ± 16 years; 10 women) who had a baseline clinical activity score of less than 4 . Participants had disease duration of 11.7 ± 2.2 months and baseline proptosis of 22.3 ± 2.9 mm.
After 24 weeks, 13 patients (86.7%) responded to treatment, showing a mean proptosis reduction of 2.9 ± 1.7 mm. In patients with a clinical activity score of less than 3, 10 of 12 (83.3%) responded to the therapy.
“The subgroup analysis also begins to really question our hypothesis that the clinical activity score is relevant in any way,” Douglas, said. “My bias is that it is not relevant in any way.”
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Douglas RS, et al. Teprotumumab efficacy in thyroid eye disease (TED) patients with low inflammation as measured by clinical activity score. Presented at: American Academy of Ophthalmology meeting; Nov. 12-15, 2021; New Orleans.
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