Neuro-Ophthalmic Literature Review

In this retrospective study the records of 119 patients who had one year of follow up after undergoing a full course of therapy with teprotumumab for thyroid eye disease (TED) were reviewed.A full course of therapy was defined as the following: 10 mg/kg for the first infusion and 20 mg/kg for subsequent infusions every 3 weeks for a total of 8 infusions over 24 weeks.The criteria for retreatment were an increase in proptosis 2 mm, a clinical activity score (CAS) 3 and worsening of diplopia in the presence of inflammatory eye signs.Three institutions participated in the study.The overall reactivation rate was 24% and this finding was similar in the three study centers.Two characteristics were noted in patients requiring retreatment.The first is that they were older, 60 12 years versus 53 16 years.The second is that they had a greater CAS (4.8 2.1 versus 3.7 1.9.However, a greater CAS may not be an independent predictor as the logistic regression analysis revealed that older patients had a greater CAS score.There was no significant difference in the rate of retreatment found in the amount of proptosis, the diplopia score, or the duration of TED.Interestingly, the use of other treatments, prior to the first infusion of teprotumumab, had no bearing on the rate of retreatment.