Journal of Thyroid Disorders & Therapy
Open Access

Abstract

Teprotumumab's Efficacy for Recurrent Severe Thyroid Eye Disease Post-Tocilizumab and Steroid Therapy

Habibullah Eatamadi*, Ohood Almazrouie, Noora AlQattan

Background/Objective: This case report aims to discuss the treatment journey of a patient with increasing thyroid eye disease-related proptosis, who has responded teprotumumab after failre with other available treatment modalities.

Case presentation: The patient was initially seen and diagnosed elsewhere with IGG4-related orbital inflammation and treated with systemic steroids. Later, he became hyperthyroid and his orbital inflammation worsened. Systemic steroids helped the inflammation slightly, but as his condition worsened, he received a cycle of 4 doses of tocilizumab, followed by another cycle of 4 doses of tocilizumab. After a prolonged period of stability, he underwent bilateral rehabilitative lateral orbital wall decompression. Unfortunately, the patient's condition relapsed again. The patient commenced an eight-dose course of teprotumumab, with each dose administered at three-week intervals. Remarkably, with each successive dose of teprotumumab, the patient demonstrated a consistent improvement in proptosis and remained free from relapse.

Discussion: Treatment with teprotumumab has resulted in favourable clinical outcomes for recurrent and severe thyroid eye disease.

Conclusions and importance: Teprotumumab played a crucial role to reverse and stabilize the condition that relapsed after systemic corticosteroid treatment, two cycles of tocilizumab and bilateral lateral orbital decompression surgery.

Published Date: 2025-01-18; Received Date: 2024-08-26