Progress in the treatment of thyroid-associated ophthalmopathy with teprotumumab

Thyroid-associated ophthalmopathy (TAO) is an autoimmune disease of complex etiology and pathogenesis, which can cause a variety of ocular manifestations and even threaten vision.Glucocorticoids are often used as the first-line treatment in the clinic, but some patients become resistant to them.The insulin-like growth factor-1 receptor (IGF-1R) plays a key role in the development of TAO.Teprotumumab is an anti-IGF-1R monoclonal antibody that can specifically bind to the IGF-1R and block its binding to the α-subunit of IGF-1 to exert biological effects.Clinical trials have shown that teprotumumab has good efficacy in reducing proptosis (decrease≥2 mm) and inflammatory activity (CAS decrease≥2 points) of active moderate-to-severe TAO.Most side effects are mild or moderate.Hyperglycemia is currently an identifiable adverse event associated with teprotumumab that can be controlled with medication.Pregnancy and inflammatory bowel disease are contraindications for teprotumumab due to its teratogenicity to the fetus and its ability to severely exacerbate inflammatory bowel disease.The US FDA has officially approved teprotumumab for the treatment of active moderate-to-severe TAO in January 2020.This article reviews the progress of clinical trials on the mechanism, efficacy and safety of teprotumumab in the treatment of TAO.

Teprotumumab; Thyroid-associated ophthalmopathy; Insulin-like growth factor 1 receptor; Drug therapy