TED is a complex autoimmune disease that can result in vision loss, disfigurement, and decreased QoL. Developments in our understanding of the pathophysiology of TED have led to a paradigm shift in TED management. Traditionally, corticosteroids, radiation therapy, and surgical correction were the mainstays of treatment. In 2020, the FDA approved teprotumumab for the treatment of TED after pivotal phase 2 and 3 RCTs showed significant improvement in proptosis, diplopia, QoL, and CAS. Teprotumumab is a promising therapy for patients with active moderate to severe TED, particularly for patients with proptosis and/or diplopia. Long-term efficacy studies are still needed to better assess the durability of all treatment options available. Several emerging treatments are in the pipeline, as research has shifted to the development of additional targeted molecular therapies. It remains to be determined how new therapeutic options will continue to change the treatment paradigm of TED.
APD, afferent pupillary defect; CAS, Clinical Activity Score; CON, compressive optic neuropathy; EUGOGO, European Group on Graves' Orbitopathy; FDA, US Food and Drug Administration; GD, Graves disease; GI, gastrointestinal; IGF-1R, insulin-like growth factor 1 receptor; IgG, immunoglobulin G; IV, intravenous; MMF, mycophenolate; ORT, orbital radiation; QoL, quality of life; RCT, randomized controlled trial; TED, thyroid eye disease; TSH, thyrotropin; TSHR, thyrotropin receptor; TSI, thyroid-stimulating immunoglobulin.
Some or all data generated or analyzed during this study are included in this published article or in the data repositories listed in "References."
J Endo Soc. 2021;5(5) © 2021 Endocrine Society