Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.
Ophthalmic Plast Reconstr Surg. 2024;40(2):187-191. doi: 10.1097/IOP.0000000000002531. Epub 2023 Oct 4.
This study analyzed the degree and timing of proptosis regression after teprotumumab therapy.
A retrospective study of all patients who completed 8 teprotumumab infusions at 1 institution from January 1, 2020 to December 31, 2022. Change in proptosis was assessed in millimeters and percentages compared with immediate post-treatment and pretreatment proptosis.
Of 119 patients with post-treatment data (mean follow-up 10.56 months, range: 3.05-25.08), 208 (87.39%) eyes of 110 patients had initial proptosis improvement. Of the 78 patients with multiple follow-up visits, 102 (65.38%) eyes of 59 patients had proptosis regression averaging 12.78% (range: 1.85-58.82%) compared with immediately post-treatment or 2.43 mm (0.5-10.0 mm). Eight (7.84%) eyes had initial documentation of regression more than 1 year after treatment, 40 (39.22%) between 6 months and 1 year, and 54 (52.94%) eyes within 6 months with 25 (46.30%) of these continuing to worsen at subsequent follow-up. Forty (25.64%) eyes of 24 patients had more proptosis at most recent follow-up than before teprotumumab, with an average regression of 1.53 mm (0.5-4.0 mm) or 7.74% (1.85-20.69%) of pretreatment proptosis. In comparison, 99 (63.46%) eyes of 54 patients maintained improvement, with reduction averaging 3.13 mm (0.5-11.0 mm) or 13.19% (1.92-41.67%) of pretreatment proptosis ( p < 0.001).
Two-thirds of eyes had regression despite initial teprotumumab response, typically within 1 year of treatment, with ongoing worsening over time. Most patients maintained some proptosis reduction compared with before treatment despite regression, although 25% were worse than pretreatment. The occurrence of regression was independent of the pretreatment duration of clinical thyroid eye disease. Overall, compared with preteprotumumab, there was a greater amount of improvement than regression at most recent follow-up.
本研究分析了特普妥单抗治疗后眼球突出度的恢复程度和时间。
这是一项回顾性研究，纳入了 2020 年 1 月 1 日至 2022 年 12 月 31 日在一家机构接受 8 次特普妥单抗治疗的所有患者。通过毫米和百分比来评估治疗后和治疗前即刻的眼球突出度变化。
在有治疗后数据的 119 例患者（平均随访 10.56 个月，范围：3.05-25.08 个月）中，110 例患者的 208 只（87.39%）眼有初始眼球突出度改善。在有多次随访的 78 例患者中，59 例患者的 102 只（65.38%）眼的眼球突出度出现平均 12.78%（范围：1.85-58.82%）的回缩，与治疗后即刻或 2.43mm（0.5-10.0mm）相比。8 只（7.84%）眼在治疗后 1 年以上首次出现回缩，40 只（39.22%）眼在 6 个月至 1 年内出现回缩，54 只（52.94%）眼在 6 个月内出现回缩，其中 25 只（46.30%）眼在随后的随访中继续恶化。24 例患者中有 40 只（25.64%）眼在最近一次随访时的眼球突出度比特普妥单抗治疗前更大，平均回缩 1.53mm（0.5-4.0mm）或回缩了治疗前眼球突出度的 7.74%（1.85-20.69%）。相比之下，54 例患者中有 99 只（63.46%）眼的改善得以维持，平均回缩 3.13mm（0.5-11.0mm）或回缩了治疗前眼球突出度的 13.19%（1.92-41.67%）（p<0.001）。
尽管有初始特普妥单抗反应，但仍有三分之二的眼出现回缩，通常发生在治疗后 1 年内，且随着时间的推移，回缩持续恶化。与治疗前相比，大多数患者的眼球突出度仍有一定程度的减少，但仍有 25%的患者比治疗前更差。眼球回缩的发生与临床甲状腺眼病的治疗前持续时间无关。总体而言，与特普妥单抗治疗前相比，最近一次随访时的改善程度大于回缩程度。
