The newly approved drug teprotumumab can offer hope to adults with thyroid eye disease, a rare and potentially blinding condition. It’s the first treatment specifically approved for thyroid eye disease. The drug of Horizon Therapeutics was approved by the U.S. Food and Drug Administration and is set to be marketed under the brand name Tepezza.
Graves’ Orbitopathy (GO) or Ophthalmopathy or Thyroid eye disease (TED) is an autoimmune disorder. The condition occurs when the same antibody causes thyroid dysfunction, which activates the receptors in the thyroid gland resulting in hyperthyroidism. This affects the eyes causing the inflammation of the eye tissues.
In a study by Zagaria et al. , it was observed that approximately 25‐30% of patients with Graves’ disease have clinical evidence of Graves’ ophthalmopathy. As per the study by Liaboe et al., titled “An Introductory Tutorial and Overview of Disease”, TED has a higher prevalence in women than men (16 per 100,000 vs. 3 per 100,000, respectively). Both men and women demonstrate a bimodal pattern of age of diagnosis (40–44 and 60–64 yearsin women; 45–49 and 65–69 years in men).
Thyroid eye disease treatment market
Thyroid eye disease treatment involves two phases. The first phase of treatment involves treating active eye disease, lasting for two-three years. The Thyroid eye diseases treatment in the active phase focuses on preserving sight and the integrity of the cornea, along with addressing double vision.
Some Thyroid eye disease treatments include medication (local therapy, antioxidant therapy, immunomodulatory therapy), and surgery (thyroidectomy and thyroid ablation).
Both active and inactive, thyroid eye disease treatment approaches are symptomatic in nature.
Local therapeutic measures such as artificial tears and ointments, sunglasses, nocturnal taping of the eyes, prisms are available to control symptoms of dryness, photophobia, and grittiness, but only in mild thyroid eye disease cases. For temporary relief from diplopia, botulinum toxin A is administered via injection in the extraocular muscles. To address swelling, selenium supplements are given.
In severe forms of the disease, high‐dose glucocorticoids and/or orbital radiotherapy, or orbital decompression are the mainstay of the thyroid eye disease treatment. High‐dose systemic glucocorticoids (GCs) are currently the first‐line treatment for moderate‐to‐severe and active TED. Intravenously administered GCs are more effective and better tolerated than oral GCs. Oral prednisone is used most often when eye-bulging and swelling continue to get worse. High dose prednisone or an intravenous corticosteroid is used if there is compression of the optic nerve.
Periocular injections of triamcinolone acetate effectively reduce diplopia and extraocular muscle size and Subconjunctival triamcinolone injections have proven to be effective in resolving eyelid swelling.
Additionally, thyroid eye disease treatment market also includes Rehabilitative (extraocular muscle or eyelid) surgery. Correction of both hyper‐ and hypothyroidism is crucial for the ophthalmopathy. Antithyroid drugs and thyroidectomy do not influence the course of the ophthalmopathy, whereas radioiodine treatment may cause the progression of pre‐existing ophthalmopathy, especially in smokers. Glucocorticoids, however, do help in preventing an exacerbation.
Other than Horizon therapeutics, Immunovant Sciences and others are working to change the dynamics of the Thyroid eye disease (TED) market is anticipated to change in the coming years owing to the expected launch of emerging therapies during the forecasted period [2019‐2028].