SUN-386 Trends And Social Determinants Of Teprotumumab Prescriptions In Thyroid Eye Disease

Abstract Disclosure: J. Lo: None. K. Ma: None. C.Y. Liu: None. D. Kaelber: None. Introduction: Teprotumumab was approved by the FDA in 2020 to treat thyroid eye disease (TED). This study examines treatment trends for TED from 2018 to 2024 and explores clinical and demographic factors of prescribing teprotumumab. Method: This retrospective observational study included patients with hyperthyroidism (ICD-10 E05) in the US between January 2018 and December 2024 using the Research network of TriNetX platform of aggregated, de-identified electronic health record data. Trends in TED treatments, including teprotumumab (RxNorm 2274803) , orbital decompression (CPT 67414, 67445, 1035648) , and intravenous (RxNorm 6902) or oral glucocorticoids (GCs) (RxNorm 8640), were assessed based on RxNorm prescription codes and CPT procedure codes. A multivariable Cox proportional hazards model was used to assess factors associated with the likelihood of receiving teprotumumab, adjusting for age, sex, race/ethnicity, and socioeconomic factors (ICD-10 Z55-65). Results: Around 100,000 patients with hyperthyroidism were identified. Among them, over 200 patients received teprotumumab annually, peaking in 2021 after FDA approval (Figure 1, left). In contrast, the number of patients undergoing orbital decompression dropped significantly after 2020 (Figure 1, center). GCs use remained relatively stable when compared to the number of patients with hyperthyroidism (Figure 1, right). Multivariable Cox regression showed that White patients were significantly more likely to receive teprotumumab than non-White patients (HR: 1.42; 95% CI: 1.25–1.62). In contrast, Black (HR: 0.67; 95% CI: 0.55–0.81) and Asian patients (HR: 0.64; 95% CI: 0.48–0.85) were significantly less likely to receive teprotumumab compared to White patients. Hispanic or Latino ethnicity was not significantly associated with teprotumumab use (HR: 0.99; 95% CI: 0.78–1.26). Patients with low socioeconomic status were significantly less likely to receive teprotumumab (HR: 0.53; 95% CI: 0.34–0.81) (Table 1). Conclusion: Compared to the number of patients with hyperthyroidism, patients receiving teprotumumab peaked in 2021 following FDA approval. In contrast, there was a decline in orbital decompression surgeries. However, disparities in access to teprotumumab remain, particularly among non-White patients and those with low socioeconomic status. Presentation: Sunday, July 13, 2025