Xu Zhibin, Hu Nan, Chen Qitao, Zhou Yue, Huang Yunye, Hu Songhao, Jin Haoru, Tang Yubo
Department of Clinical Research, First Affiliated Hospital of Jinan University, Guangzhou, China.
Clinical Research Center (CRC), The First Affiliated Hospital of Jinan University, Guangzhou, China.
Front Endocrinol (Lausanne). 2025 May 27;16:1480195. doi: 10.3389/fendo.2025.1480195. eCollection 2025.
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.
替普罗单抗在治疗甲状腺眼病（TED）方面已显示出显著疗效，但其不良反应需要谨慎处理。主要反应包括听力障碍、高血糖以及可能使既往存在的炎症性肠病（IBD）加重。听力障碍可能是由于胰岛素样生长因子1受体（IGF-1R）受到抑制，表现为更严重的感音神经性改变。高血糖是由生长激素反馈紊乱导致的，并且既往使用糖皮质激素可能会使其恶化。虽然替普罗单抗似乎不会诱发新的糖尿病病例，但它会使现有的高血糖加重。还观察到了认知问题、输液反应以及其他不良反应，如肌肉痉挛和体重减轻。处理需要对患者进行仔细筛查，特别是对于有听力损失、糖尿病或IBD病史的患者。进一步的研究对于阐明这些不良反应的潜在机制以及制定有针对性的预防策略以提高替普罗单抗在临床实践中的安全性和疗效至关重要。
