Reduction of Teprotumumab-Induced Hearing Loss With Comparable Efficacy Using Half-Dose Therapy.

Abstract

Teprotumumab has been shown to be effective in the treatment of thyroid eye disease, a potentially vision-threatening condition. Adverse events, including sensorineural hearing loss, have been associated with teprotumumab. The authors present the case of a 64-year-old female who discontinued teprotumumab due to significant sensorineural hearing loss after 4 infusions, along with other adverse events. The patient was unresponsive to a subsequent course of intravenous methylprednisolone and orbital radiation, during which she experienced worsening thyroid eye disease symptoms. Teprotumumab was restarted 1 year later, at a half dose of 10 mg/kg for 8 infusions. Three months post-treatment, she retains resolution of double vision and orbital inflammatory signs, and significant improvement in proptosis. She tolerated all infusions with an overall reduction in the severity of her adverse events and without return of significant sensorineural hearing loss. The authors conclude that a lower dose of teprotumumab can be effective for patients with active moderate-severe thyroid eye disease who experience significant or intolerable adverse events.

• Authors: Ragini Phansalkar, Tracy Lu, Jennifer Alyono, Jennifer Lee, Chrysoula Dosiou, Andrea Lora Kossler
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2023 Jul-Aug 01 Vol. 39 Issue 4 Pg. e101-e104 ISSN: 1537-2677 [Electronic] United States
• PMID: 36877549 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Chemical References

• teprotumumab
• Antibodies, Monoclonal, Humanized

Topics

• Humans
• Female
• Middle Aged
• Graves Ophthalmopathy (drug therapy)
• Antibodies, Monoclonal, Humanized (adverse effects)
• Exophthalmos
• Hearing Loss, Sensorineural (chemically induced, diagnosis, drug therapy)