Teprotumomab for treatment of thyroid eye disease or Grave's orbitopathy (New Drug 2020)

Teprotumomab for treatment of thyroid eye disease or Grave's orbitopathy (New Drug 2020)

Teprotumomab is an anti IGF-1 (Insulin Like Growth Factor-1) receptor monoclonal antibody approved for treatmnent of thyroid eye disease or Grave's orbitopathy.

It is given by contnuous intravenous infusion 8 times. The first infusion is given at dose of 10 mg/kg body weight. The other 7 infusions are given at a dose of 20 mg/kg body weight.

Side-effects associated are hyperglycemia, hearing loss and worsening of inflammatory bowel disease.

In thyroid eye disease there is an increased permeability of leucocytes in to eyeball, which produce antibodies which stimulate IGF-1 receptor in orbital fibroblast and increase production of hyaluronan. Hyaluronan interacts with mononuclear cells and causes orbital remodelling due to sclerosis and fibrosis. This leads to the orbital findings of proptosis and lid retraction.

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