Teprotumumab Use in Thyroid Eye Disease: Clinical Outcomes in the United Arab Emirates- a First Regional Case Series.

Background: Thyroid eye disease (TED), an autoimmune disorder frequently associated with Graves' disease, manifests as orbital inflammation, proptosis, diplopia, and vision impairment, significantly diminishing quality of life. Traditional treatments, such as corticosteroids and rituximab, exhibit variable efficacy, while targeted therapies like teprotumumab, an insulin-like growth factor-1 receptor (IGF-1 R) inhibitor, have shown promise, particularly in the United States. However, data from the Middle East, including the United Arab Emirates (UAE), remain scarce, highlighting the need for regional studies.

Objective: To evaluate the clinical efficacy and safety of teprotumumab in TED patients in the UAE, presenting the first case series from the Gulf region.

Methods: This retrospective case series analysed 14 patients (25 eyes) with moderate-to-severe TED who completed eight teprotumumab cycles. Outcomes-proptosis reduction (primary), Clinical Activity Score (CAS), double vision, quality of life (TED-QOL), stability, and adverse effects-were assessed at 24 weeks and 6 months post-treatment using standardized measures.

Results: Teprotumumab reduced proptosis by 2.64 mm at 24 weeks (p < .0001) and 2.32 mm at 6 months (p < .0001), with 68% of eyes achieving ≥ 2 mm reduction. CAS dropped from 5.21 to 0.35 (p < .0001), double vision improved in 85.7% of cases, and QoL enhanced across all domains (p < .001). Stability persisted at 6 months, with tolerable adverse effects.

Conclusion: Teprotumumab is effective and safe for TED in the Gulf region, offering sustained benefits. Larger, longer-term studies are needed to confirm efficacy, recurrence, and safety.