Teprotumumab outclasses glucocorticoids in thyroid eye disease

Compared with intravenous (IV) or oral glucocorticoids (GCs), the use of teprotumumab results in lower risks of mortality and cardiovascular, renal, and infectious outcomes in patients with thyroid eye disease (TED), suggests a study.

Treatment with teprotumumab correlated with a significant reduction in all-cause mortality (vs IV GCs: hazard ratio [HR], 0.32, 95 percent confidence interval [CI], 0.16‒0.65; vs oral GCs: HR, 0.20, 95 percent CI, 0.10‒0.39) and in the risks of acute myocardial infarction (vs IV GCs: HR, 0.37, 95 percent CI, 0.15‒0.95; vs oral GCs: HR, 0.33, 95 percent CI, 0.12‒0.91) and acute kidney failure (vs IV GCs: HR, 0.54, 95 percent CI, 0.31‒0.94; vs oral GCs: HR, 0.37, 95 percent CI, 0.22‒0.63).

Teprotumumab also reduced the risks of emergency department visits (vs IV GCs: HR, 0.48, 95 percent CI, 0.38‒0.60; vs oral GCs: HR, 0.60, 95 percent CI, 0.48‒0.75), hospitalizations (vs IV GCs: HR, 0.31, 95 percent CI, 0.23‒0.40; vs oral GCs: HR, 0.34, 95 percent CI, 0.26‒0.45), urinary tract infection (vs IV GCs: HR, 0.60, 95 percent CI, 0.41‒0.89; vs oral GCs: HR, 0.58, 95 percent CI, 0.40‒0.86), pneumonia (vs IV GCs: HR, 0.37, 95 percent CI, 0.22‒0.61; vs oral GCs: HR, 0.33, 95 percent CI, 0.20‒0.53), and severe sepsis (vs IV GCs: HR, 0.24, 95 percent CI, 0.10‒0.64; vs oral GCs: HR, 0.31, 95 percent CI, 0.11‒0.84).

Patients on teprotumumab also showed lower all-cause mortality than those on conservative treatment (HR, 0.24, 95 percent CI, 0.13‒0.45).

“Teprotumumab may result in fewer adverse outcomes than systemic GCs for treating TED,” the investigators said.

This population-based cohort study involved patients with TED who initiated teprotumumab, GCs, or conservative treatment between 1 January 2020 and 1 December 2024 from 80 healthcare organization in the US.