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REVIEW article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1480195
This article is part of the Research Topic The Association of Other Autoimmune Diseases in Patients with Thyroid Autoimmunity: Volume II View all 19 articles
Teprotumumab in the Management of Thyroid Eye Disease Mechanistic Insights and Adverse Reactions: A Comprehensive Review
Provisionally accepted
Zhibin Xu 1,2,3,4*
Nan Hu 5 Qitao Chen 6 Yue Zhou 6 Yunye Huang 7 Songhao Hu 8
haoru jin 9
Yubo Tang 10*- 1 First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- 2 National Clinical Research Center for Respiratory Diseases, Guangzhou, China
- 3 Guangzhou Institute of Respiratory Health, Guangzhou, China
- 4 State Key Laboratory of Respiratory Diseases (SKLRD), Guangzhou, Guangdong Province, China
- 5 Department of Clinical Research, First Affiliated Hospital of Jinan University, Guangzhou, China
- 6 Sanming Hospital of Integrated Traditional Chinese and Western Medicine, Sanming, China
- 7 Department of Otolaryngology, The First Affiliated Hospital of Jinan University, Guangzhou, China
- 8 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- 9 Guangzhou Medical University, Guangzhou, Guangdong Province, China
- 10 Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Teprotumumab has shown significant efficacy in treating Thyroid Eye Disease (TED), but its adverse effects require careful management. Key reactions include hearing impairment, hyperglycemia, and potential exacerbation of pre-existing inflammatory bowel disease (IBD). Hearing impairment, likely due to inhibition of the insulin-like growth factor 1 receptor (IGF-1R), manifests as more severe sensorineural changes. Hyperglycemia results from disrupted growth hormone feedback and may be worsened by prior glucocorticoid use. Although teprotumumab does not appear to induce new diabetes cases, it can exacerbate existing hyperglycemia. Cognitive issues, infusion reactions, and other adverse effects, such as muscle cramps and weight loss, have also been observed. Management requires careful patient screening, particularly for those with histories of hearing loss, diabetes, or IBD. Further research is essential to elucidate the underlying mechanisms of these adverse effects and develop targeted preventive strategies to improve the safety and efficacy of teprotumumab in clinical practice.
Keywords: teprotumumab, Thyroid eye disease (TED), Adverse Reactions, hearing impairment, Hyperglycemia, Inflammatory bowel disease (IBD)
Received: 13 Aug 2024; Accepted: 03 Mar 2025.
Copyright: © 2025 Xu, Hu, Chen, Zhou, Huang, Hu, jin and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhibin Xu, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Yubo Tang, Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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