Teprotumumab Improved Ocular Surface Disease Symptoms in Patients With TED

Researchers also noted improvements in patients’ visual functioning-related quality of life.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

Teprotumumab improved ocular surface disease symptoms and quality of life related to visual functioning in patients with thyroid eye disease (TED), researchers reported in a study they presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium in New Orleans, November 11-12.

Most patients with TED have ocular surface symptoms. Prior research has indicated that increased corneal exposure, tear film evaporation, and ocular surface inflammation are likely intermediary factors. Researchers sought to determine the relationship teprotumumab has with ocular surface disease in patients with TED.

They conducted a prospective cohort study of 16 patients (mean age 52 years, 13 women) with moderate to severe TED and dry eye symptoms who had received 8 infusions of teprotumumab. The investigators evaluated clinical signs of conjunctival injection and chemosis, Schirmer testing, and Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire responses. Researchers evaluated meibomian gland loss via infrared meibography and assigned 4-point ImageJ scale scores based on percentage of meibomian gland loss. To describe quality of life changes, the investigators utilized portions of the Graves’ Ophthalmopathy-Specific Quality of Life (GO-QOL) questionnaire.

After 24 weeks of treatment, patients experienced significantly less severe and less frequent dry eye symptoms and lower SPEED scores (9.81±5.98) compared with baseline (15.88±4.47, P =.001). Conjunctivitis resolved in 53.33% of cases and improved in 46.67% of cases. Chemosis resolved in 87.5% of cases and improved in the rest of the cases. Quality of life measurements of visual functioning improved from 54.61±24.18 to 79.76±23.47 (P =.00018).

Meibomian gland loss grade improved in 35.71% of patients as meibomian gland dropout rate decreased from 46%±15.16% to 35%±12.59% (P =.059). Schirmer test results improved from 17.13±10.29 to 20.14±11.77, and Schirmer tear volumes nearly doubled, improving from 7.14±2.73 to 13.65±10.01, in eyes with less than 10 mm wetting in 5 minutes (P =.151).

Limitations of the study include limited follow-up.

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Lu L, Sears C, Liu J, et al. Effect of teprotumumab on ocular surface disease in active thyroid eye disease. Poster presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.