Jui-En Lo, MD, Resident of Internal Medicine at MetroHealth, discusses trends and social determinants of teprotumumab in thyroid eye disease (TED).
TED is a rare autoimmune disease that can dramatically impact a person’s vision. The condition often occurs in people with hyperthyroidism or Graves’ disease (GD), but also can occur in association with hypothyroidism, euthyroidism, and Hashimoto’s thyroiditis. GD affects approximately 1% to 2% of the adult population, with an estimated 40% of GD patients subsequently developing TED over the course of their lifetime. The onset of TED typically occurs between 30 and 50 years of age, with the disease course more severe after age 50. Common symptoms can include upper eyelid retraction, dry eyes, inflammation, light sensitivity, as well as the sensation of a foreign body present in the eye.
Teprotumumab
Teprotumumab is a monoclonal antibody that targets the insulin-like growth factor-1 receptor (IGF-1R), inhibiting orbital fibroblast activation. It was approved for treatment of TED by the U.S. Food and Drug Administration (FDA) in 2020. A study presented at the ENDO 2025 meeting examined treatment trends for TED and explored clinical and demographic factors of prescribing teprotumumab. The study was retrospective and observational and included 100,000 patients with hyperthyroidism between 2018 and 2024.
Of these 100,000 patients, over 200 received teprotumumab annually, with a peak in 2021 following the FDA approval. Additionally, the number of patients undergoing orbital decompression significantly dropped after 2020. Glucocorticoid use remained relatively stable compared to the number of patients with hyperthyroidism.
Multivariable Cox regression showed that White patients were significantly more likely to receive teprotumumab than non-White patients. Specifically, Black and Asian patients were significantly less likely to receive the treatment compared to White patients but Hispanic or Latino ethnicity was not significantly associated with use of teprotumumab. Additionally, patients with low socioeconomic status were significantly less likely to receive teprotumumab.
To learn more about thyroid eye disease and other rare endocrine conditions, visit https://checkrare.com/diseases/endocrine-disorders/
