REVIEW article

Front. Endocrinol.

Sec. Thyroid Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1480195

This article is part of the Research TopicThe Association of Other Autoimmune Diseases in Patients with Thyroid Autoimmunity: Volume IIView all 20 articles

Teprotumumab in the Management of Thyroid Eye Disease Mechanistic Insights and Adverse Reactions: A Comprehensive Review

Provisionally accepted
Zhibin  XuZhibin Xu1,2,3,4*Nan  HuNan Hu5Qitao  ChenQitao Chen6Yue  ZhouYue Zhou6Yunye  HuangYunye Huang7Songhao  HuSonghao Hu8haoru  jinhaoru jin9Yubo  TangYubo Tang10*
  • 1First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • 2National Clinical Research Center for Respiratory Diseases, Guangzhou, China
  • 3Guangzhou Institute of Respiratory Health, Guangzhou, China
  • 4State Key Laboratory of Respiratory Diseases (SKLRD), Guangzhou, Guangdong Province, China
  • 5Department of Clinical Research, First Affiliated Hospital of Jinan University, Guangzhou, China
  • 6Sanming Hospital of Integrated Traditional Chinese and Western Medicine, Sanming, China
  • 7Department of Otolaryngology, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 8Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 9Guangzhou Medical University, Guangzhou, Guangdong Province, China
  • 10Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

The final, formatted version of the article will be published soon.

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

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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