Tepezza was approved in January 2020 as the first nonsurgical treatment for thyroid eye disease (TED), a condition that causes eye bulging and vision problems. The new drug is delivered through an IV and accomplishes what surgery often cannot, experts say.
“This is an exciting milestone for the treatment of this debilitating disease,” said Christopher Starr, MD, an associate professor of ophthalmology at Weill Cornell Medical Center. “Many people on Tepezza had complete resolution of eye protrusion, pain and vision loss.”
One million Americans are diagnosed with TED each year. The disease most often affects people with an overactive thyroid gland, or Graves’ disease. But TED can also occur in patients without Grave’s disease. Cigarette smokers and women have a higher risk than others of developing the disease.
People with TED experience inflammation and swelling behind the eyes, causing the eyes to bulge outward. This can lead to blurred vision, double vision, dryness, redness and pain. Sometimes TED causes permanent blindness.
Surgery can reposition the eye and its muscles to improve vision and aesthetics. But even repeated surgeries do not completely restore the eyes to their normal state. The new drug, also known as teprotumumab-trbw, may change that.
Tepezza works by relieving the inflammation underlying TED. Treatment is most effective when given during the beginning stages of TED. There may still be some benefit of Tepezza in patients stable disease who experience eye bulging or double vision.
The drug can be prescribed by different types of doctors including ophthalmologists, rheumatologists or endocrinologists. Most patients will receive the IV treatment at a specialized outpatient infusion center. Each procedure takes about one hour, and most patients are able to return home the same day.
Tepezza may not be right for patients who are pregnant or breastfeeding, or have diabetes or an inflammatory bowel condition such as Crohn’s disease or ulcerative colitis.
The most common side effects of Tepezza include muscle cramps or spasms, nausea, hair loss, diarrhea, fatigue, high blood sugar, hearing problems, taste changes, headache or dry skin. Some people develop reactions to the IV infusion within 24 hours and need additional care. A small, preliminary study suggests that hearing problems may affect as many as 65% of patients treated with Tepezza. Until more is known about the effects of Tepezza on hearing, ask your doctor if the possible risks are worth the benefits.
New drugs for rare diseases such as TED are often very expensive. Tepezza is estimated to cost about $14,900 per vial, with full treatment over six months costing approximately $200,000. Insurance coverage and patient out of pocket costs will vary based on p