Efficacy and Safety of Teprotumumab in Thyroid Eye Disease: A Systematic Review and Meta-Analysis.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-02-12 DOI:10.1016/j.eprac.2025.01.012

Wenxin Huang, Xiaodan Ou, Shuzhen Lin, Wei Lin, Gang Chen, Huibin Huang, Junping Wen

{"title":"Efficacy and Safety of Teprotumumab in Thyroid Eye Disease: A Systematic Review and Meta-Analysis.","authors":"Wenxin Huang, Xiaodan Ou, Shuzhen Lin, Wei Lin, Gang Chen, Huibin Huang, Junping Wen","doi":"10.1016/j.eprac.2025.01.012","DOIUrl":null,"url":null,"abstract":"Objectives: Teprotumumab was approved by the FDA for treating Graves' orbitopathy (GO) in adults on January 21, 2020. This study evaluates its efficacy and safety in treating thyroid eye disease (TED).Methods: We reviewed studies on teprotumumab for TED treatment from PubMed, Web of Science, EMBASE, Cochrane library, and Clinical trials.gov up to January 1, 2024. Outcomes included proptosis response, diplopia, CAS score, and adverse events (AEs).Results: Our analysis included ten studies, four randomized controlled trials (RCTs), and six observational studies. The RCTs involved 210 teprotumumab patients and 193 controls. Teprotumumab significantly improved proptosis response (RR 4.18, 2.72-6.43), diplopia regression (RR 2.29, 1.54-3.41), and CAS score (RR 3.09, 1.98-4.80) compared to placebo. A significant reduction in proptosis was observed (SMD-8.38, -9.25 - -7.52). The risk of AEs and serious AEs was higher with teprotumumab. The six observational studies included 211 patients, showing an 82% proptosis response rate, a -3.31mm change in proptosis, a 0.58 diplopia improvement rate, and a 0.66 pooled effect size for CAS score. AE incidence was 0.78, and serious AEs were 0.31.Conclusions: Teprotumumab effectively reduces proptosis, improves diplopia, and lowers disease activity in TED, regardless of previous treatments, severity, or dosage, albeit with increased AEs. It has the potential to become a vital first-line treatment for TED, enhancing patient quality of life.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.eprac.2025.01.012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Teprotumumab was approved by the FDA for treating Graves' orbitopathy (GO) in adults on January 21, 2020. This study evaluates its efficacy and safety in treating thyroid eye disease (TED).

Methods: We reviewed studies on teprotumumab for TED treatment from PubMed, Web of Science, EMBASE, Cochrane library, and Clinical trials.gov up to January 1, 2024. Outcomes included proptosis response, diplopia, CAS score, and adverse events (AEs).

Results: Our analysis included ten studies, four randomized controlled trials (RCTs), and six observational studies. The RCTs involved 210 teprotumumab patients and 193 controls. Teprotumumab significantly improved proptosis response (RR 4.18, 2.72-6.43), diplopia regression (RR 2.29, 1.54-3.41), and CAS score (RR 3.09, 1.98-4.80) compared to placebo. A significant reduction in proptosis was observed (SMD-8.38, -9.25 - -7.52). The risk of AEs and serious AEs was higher with teprotumumab. The six observational studies included 211 patients, showing an 82% proptosis response rate, a -3.31mm change in proptosis, a 0.58 diplopia improvement rate, and a 0.66 pooled effect size for CAS score. AE incidence was 0.78, and serious AEs were 0.31.

Conclusions: Teprotumumab effectively reduces proptosis, improves diplopia, and lowers disease activity in TED, regardless of previous treatments, severity, or dosage, albeit with increased AEs. It has the potential to become a vital first-line treatment for TED, enhancing patient quality of life.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.