Teprotumumab-associated hearing-related adverse events

This study aims to provide a review of the existing literature on teprotumumab (Tepezza)-associated hearing-related adverse effects. A review of PubMed and Embase was conducted using keywords “teprotumumab,” “tepezza,” “hearing disorder[s],” “hearing loss,” and “ototoxicity.” These search results were filtered to include all clinical trials, observational studies, case reports, and case series relevant to the topic of teprotumumab-associated hearing disorders. Data collection from the 15 included studies consisted of: sample size, number and percentage of hearing disorders reported, types of hearing disorders, remission rates, timeline of symptom onset, predisposing risk factors, suggested screening guidelines, and treatment proposals. Teprotumumab-associated hearing disorders are reported in 7-81.5% (median 12%) of clinical study participants. Symptoms described include sensorineural hearing loss (SNHL), hypoacusis, autophony, ear fullness/pressure/plugging, patulous eustachian tube, and tinnitus. Most symptoms improve with discontinuation of teprotumumab, but some symptoms persist after completion of treatment, most commonly SNHL. Symptoms have been reported occurring 3-37 (median 8.4) weeks after treatment initiation, with the majority reported 6 weeks after treatment initiation. Additional prospective studies are needed to clarify how frequently teprotumumab causes ototoxicity. There remains a need for both standardized audiologic screening guidelines and treatment for patients in whom ototoxicity persists post-treatment.   Key Words: teprotumumab, tepezza, hearing disorder[s], hearing loss, ototoxicity