Joshua Van Swol, Jenna Spinello, Milan Bimali, Andrew Davis, Jade Burriss, Addie Flowers, Coby Ray, Jeremy J Donai
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引用次数: 0
Abstract
Purpose: To prospectively evaluate audiologic outcomes in patients with thyroid eye disease (TED) treated with teprotumumab, focusing on longitudinal changes in hearing sensitivity and cochlear function.
Methods: Adult patients initiating teprotumumab therapy at a tertiary care center (2023-2025) underwent audiologic evaluations before, during, and after treatment. Pure-tone audiometry (500-12,500 Hz) and distortion product otoacoustic emissions (DPOAEs; 842-7996 Hz) were analyzed using three-level mixed-effects models to assess longitudinal changes, with secondary analyses controlling for baseline hearing loss.
Results: Sixteen participants completed the study. Significant threshold elevations suggesting reduced hearing sensitivity were observed in 6 of 9 audiometric frequencies (p < 0.05), most prominent during active therapy. Partial recovery occurred post-treatment, though thresholds rarely returned to baseline. DPOAE analyses showed fewer consistent changes, with significant amplitude reductions at only 4 of 24 frequencies. Adjusting for baseline hearing loss reduced significance for isolated measures but not overall trends. As multiple comparisons were not formally adjusted for, these findings should be interpreted as exploratory and hypothesis-generating.
Conclusions: Teprotumumab therapy appears to be associated with sensorineural hearing decline detected by audiometry but incompletely captured by DPOAEs. This mismatch suggests injury beyond outer hair cells, possibly involving inner hair cells or neural elements. These findings may support audiometric monitoring during treatment and further research into teprotumumab's ototoxic mechanisms during treatment of TED.
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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