Analysis of teprotumumab-trbw use shows small percentage of patients receive a second course of treatment

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Teprotumumab-trbw is the first and only medicine approved by the FDA for the treatment of thyroid eye disease.

Horizon Therapeutics plc has announced new data from a real-world analysis of teprotumumab-trbw (Tepezza) presented at the 91st annual Meeting of the American Thyroid Association.

According to the company, teprotumumab-trbw is the first and only medicine approved by the FDA for the treatment of thyroid eye disease (TED) – a serious, progressive and potentially vision-threatening rare autoimmune disease.1

Evidence has indicated that due to the progressive nature of TED, the disease may reactivate, or flare. In a retrospective chart review, up to 15% of patients experienced a TED flare, regardless of treatment regimen. While many causes for reactivation are unknown, some triggers include pregnancy, stress and surgery.2

The real-world analysis assessed deidentified claims data from people living with TED who completed a full, uninterrupted course of teprotumumab-trbw (8 infusions) in 2020 and then subsequently were prescribed a second course of treatment prior to July 2022. During this two-year period, 4.9% (286/5,845) of patients were prescribed a second course of teprotumumab-trb. 1.9% (110/5,845) of the total patients went on to initiate treatment by the end of the two-year period, with a mean time of 12 months between courses.3

“Treating an autoimmune condition like Thyroid Eye Disease that may worsen or flare over time is challenging,” said Shoaib Ugradar, MD, The Jules Stein Eye Institute at University of California, Los Angeles (UCLA). “These data indicate that the need is low for additional treatment with Tepezza for those living with thyroid eye disease who have completed an initial course. With continued analysis and research, we hope to come closer to identifying specific causes and indicators for additional treatment in order to better manage this debilitating, life-long condition.”

Horizon also announced results from a 2018 U.S. survey of endocrinologist and ophthalmologists comparing the impact of shorter versus longer duration TED in patients with a high Clinical Activity Score (CAS). The analysis looked at those with a CAS ≥ 3, who had lived with TED for less than or equal to three years (n = 192) versus over three years (n = 115). Both shorter and longer duration groups reported comparable overall negative mental health impact (38.5% vs. 35.7%, respectively) and experience with anxiety and depression. They both also reported a similar negative effect of TED on their quality of life, as measured by a seven-point Likert scale, including social and daily activities.4

“Thyroid eye disease, regardless of years since diagnosis, can significantly impact a person’s ability to look and feel like themselves and may affect daily tasks from reading to driving a car,” Jeffrey W. Sherman, MD, FACP, executive vice president, chief medical officer, Horizon, said in the news release. “These survey results emphasize the burden of disease for those living with thyroid eye disease and underscore the need for appropriate care with treatment as soon as possible.”

References

  1. Barrio-Barrio J, et al. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. Journal of Ophthalmopathy. 2015;2015:249125.
  2. Patel P, et al. Recurrent Thyroid Eye Disease. Ophthalmic Plastic and Reconstructive Surgery. 2015; 31:445-8.
  3. Smith TJ, et al. Evaluation of United States Thyroid Eye Disease Patients Receiving an Additional Course of Teprotumumab Treatment over 2 years. Poster session presented at: Annual Conference of American Thyroid Association (ATA); 2022 October 19-23; Montreal, Quebec, Canada.
  4. Smith TJ, et al. Sequalae of Shorter versus Longer Duration Inflammatory Thyroid Eye Disease. Poster session presented at: Annual Conference of American Thyroid Association (ATA); 2022 October 19-23; Montreal, Quebec, Canada.