AAO 2026: Elegrobart reduces proptosis in active thyroid eye disease

At the American Academy of Ophthalmology (AAO) 2026 Annual Meeting in New Orleans, Louisiana, Michael T. Yen, MD, a professor of ophthalmology at Baylor College of Medicine in Houston, Texas, spoke with Ophthalmology Times about results from the phase 3 REVEAL-1 trial (NCT06812325). The trial evaluated subcutaneous elegrobart (Viridian Therapeutics) in patients with active thyroid eye disease (TED). Elegrobart significantly reduced proptosis compared with placebo with both every-4-week and every-8-week dosing. REVEAL-1 randomly assigned 132 patients 1:1:1 to elegrobart every 4 weeks (Q4W), elegrobart every 8 weeks (Q8W), or placebo.¹

Why does subcutaneous delivery matter in TED?

TED can cause significant visual and overall health debilitation, and current insulin-like growth factor 1 receptor (IGF-1R)–targeted monoclonal antibodies require intravenous (IV) infusion. Elegrobart also targets IGF-1R but is administered subcutaneously, which Yen told Ophthalmology Times at AAO 2026 “really decreases the treatment burden for the patients.” A subcutaneous option would spare patients the logistics of traveling to an infusion center, time away from their schedules, and lengthy infusion sessions. Yen added that subcutaneous dosing may also produce a different adverse event profile because drug levels do not peak as rapidly.

What did REVEAL-1 show for proptosis and diplopia?

Both dosing regimens significantly improved proptosis compared with placebo. The proptosis responder rate, defined as a reduction of more than 2 mm in how far the eyes protrude, and the mean change from baseline were significant in both treatment arms. Yen noted that both arms achieved more than 2 mm of proptosis reduction.

Diplopia, a common symptom in patients with TED, was a secondary end point. Yen reported that about 70% of patients in the Q4W arm had improvement in diplopia, and more than half had complete resolution.

How did elegrobart perform on hearing safety?

Yen said elegrobart was very well tolerated overall, with very few patients discontinuing treatment. Because hearing impairment has been a particular focus, he outlined the hearing events in detail. All hearing impairment events in the treatment arms were tinnitus, and 1 patient in the placebo group had hypoacusis. Yen estimated that 12% to 14% of patients in the Q4W arm and fewer than 10% in the Q8W arm reported hearing impairment symptoms. Viridian reported placebo-adjusted hearing impairment rates of 11.3% and 2.3%, respectively.¹

For more from the meeting, visit Ophthalmology Times’ AAO 2026 coverage.

References
1. Viridian Therapeutics. Viridian Therapeutics announces positive topline results from elegrobart phase 3 REVEAL-1 clinical trial in active thyroid eye disease. News release. March 30, 2026. Accessed October 10, 2026. https://investors.viridiantherapeutics.com/news/news-details/2026/Viridian-Therapeutics-Announces-Positive-Topline-Results-from-Elegrobart-Phase-3-REVEAL1-Clinical-Trial-in-Active-Thyroid-Eye-Disease/default.aspx