Teprotumumab for the treatment of thyroid eye disease

ABSTRACT

Introduction

Thyroid eye disease is a debilitating, disfiguring, and potentially blinding periocular condition. Teprotumumab is a human insulin-like growth factor-I receptor monoclonal inhibitor antibody which indicated for treating thyroid eye disease.

Areas covered

The authors performed a systematic review of the literature using the PubMed database, and the following keywords were used: ‘teprotumumab,’ ‘thyroid eye disease,’ and ‘insulin-like growth factor I receptor.’ The chemical property, mechanism of action, pharmacokinetics, clinical efficacy, and safety of teprotumumab were introduced in this paper.

Expert opinion

Teprotumumab is a human monoclonal antibody targeting insulin-like growth factor-I receptor. Clinical trials indicated that proptosis response of teprotumumab was 83%, and clinical activity score, diplopia, and quality of life were also better than placebo. Teprotumumab was well tolerated, common adverse reactions included muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, and dry skin.

KEYWORDS:

• Thyroid eye disease
• insulin-like growth factor I receptor
• teprotumumab
• thyrotropin receptor
• monoclonal antibody

Article highlights

• Teprotumumab is a fully human monoclonal insulin-like growth factor- I receptor inhibitor.

• Cmax is 632 μg/mL. AUC is 138mg•hr/mL, volume of distribution is 3.26 L, elimination half-life is 20 days, and clearance is 0.27 L/day.

• The recommended dose is 10 mg/kg for the initial dose followed by 20 mg/kg every three weeks for 7 additional doses, administered intravenously.

• Common adverse reactions include muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, and dry skin.

• Clinical trial:NCT01868997, NCT03298867, and NCT03461211.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded