Teprotumumab and Orbital Decompression for the Management of Proptosis in Patients With Thyroid Eye Disease.
Journal
Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431
Informations de publication
Date de publication:
16 Nov 2023
16 Nov 2023
Historique:
medline:
17
11
2023
pubmed:
17
11
2023
entrez:
16
11
2023
Statut:
aheadofprint
Résumé
To compare outcomes of patients with thyroid eye disease treated with teprotumumab or orbital decompression, or both in sequence. Patients with thyroid eye disease and treated with decompression, teprotumumab, or both were included. Four groups were defined: decompression only, teprotumumab only, teprotumumab first with decompression later, and decompression first with teprotumumab later. The primary outcome was change in exophthalmometry. Secondary outcomes included change in extraocular muscle motility, strabismus, diplopia, and side effects. One hundred and thirty-nine patients were included. The mean duration for early follow-up was 1.2 months for both decompression and teprotumumab groups. The mean late follow-up was 14.4 and 8.2 months for the decompression and teprotumumab groups respectively. Mean change in exophthalmometry was significantly greater for the decompression group (3.5 mm) compared with teprotumumab (2.0 mm) at late follow-up. Improvement in total extraocular muscle restriction was significantly greater in the teprotumumab group (14.7 degrees) than in the decompression group (2.6 degrees). The teprotumumab group had a significantly higher percentage of patients with diplopia score >1 at baseline and late follow-up (p < 0.01) compared with the decompression group. Additional treatment with teprotumumab or decompression when previously treated with the opposite had similar proptosis reduction effect as that therapy alone. Surgical decompression has a greater proptosis reduction effect than teprotumumab, whereas teprotumumab better improves extraocular muscle motility. The addition of teprotumumab or decompression to a previous course of the opposite adds a similar effect to the supplemental treatment alone.
Identifiants
pubmed: 37972968
doi: 10.1097/IOP.0000000000002563
pii: 00002341-990000000-00282
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Déclaration de conflit d'intérêts
D.B.R. is a consultant for Horizon Therapeutics. The other authors have no conflicts of interest to disclose.
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