‘Game changer’ therapy reduces inflammation in Graves’ orbitopathy
WAIKOLOA, Hawaii — Teprotumumab is in the last year of phase 3 clinical trials and could be a “breakthrough game changer” in treatment of Graves’ orbitopathy, Roger A. Dailey, MD, FACS, said at Hawaiian Eye 2019.
Considering autoantibodies stimulate cell surface antigens on orbital cells and produce the cascade of events that result in characteristic orbital thyroid eye disease inflammation, “it would be nice to have something that would block all those receptors competitively and keep the autoantibodies from turning on this whole series of inflammation,” Dailey said.
Phase 2 clinical trial results for teprotumumab (River Vision Development) were reported in the New England Journal of Medicine in 2017. Even though phase 3 clinical trial results are not yet available, “We’ve certainly been able to show that it reduces the inflammation, it reduces the proptosis, it reduces the clinical activity score, and then you just don’t get any of that inflammation,” Dailey said.
Teprotumumab blocks underlying autoimmune mechanism, shuts down activation of fibroblasts, promotes resolution of inflammation, minimizes tissue expansion and acts to preserve the orbit in its normal state, he said.
In the past, decompression efforts have been targeted at reducing inflammation after active phase of the disease.
“If we identify the problem early on in its active phase, then we might see that we can shut down the inflammation,” Dailey said. – by Patricia Nale, ELS
Dailey RA. ‘TED’ talk: Evaluation and treatment options for thyroid eye disease. Presented at: Hawaiian Eye; Jan. 19-25, 2019; Waikoloa, Hawaii.
Disclosures: Dailey reports no relevant financial disclosures.