Teprotumumab Treatment in a Patient With Longstanding Thyroid Eye Disease

Thyroid eye disease (TED), is an autoimmune disorder of retrobulbar tissue.1 The most common presentations of TED include eyelid retraction, dryness, injection, diplopia, blindness or proptosis.1 During the active phase, treatments include systemic corticosteroids, orbital radiotherapy, and agents including rituximab.1 During the inactive phase, treatments include orbital decompression, strabismus surgery, eyelid retraction repair and tarsorrhaphy.2 In January 2020, the U.S. Food and Drug Administration approved teprotumumab for the treatment of adults with active TED. Notably, patients with previous treatment with steroids, immunomodulatory agents, surgery, or orbital irradiation were excluded from clinical trials. We describe using teprotumumab in a patient with long-standing TED and an extensive treatment history.