Teprotumumab for TED Worsens Glycemic Control

The present study showcased the impact teprotumumab has on glycemic control. It can take several months for patients to return to their baseline HbA1c measurement after presenting with worsening glycemic control. For diabetic patients, it took a median of 13.1 months; for those with prediabetes, it took a median of 7.7 months; and for normoglycemic patients, it took a median of 6.4 months. Photo: Jacob Lang, OD. Click image to enlarge. Researchers from Massachusetts Eye and Ear in Boston conducted a study to examine HbA1c levels in patients who began treatment for thyroid eye disease (TED).This study was undertaken to understand whether teprotumumab was impacting the glycemic control of TED patients who have or are at risk of diabetes. Patients’ HbA1c measurements were taken pre- and post-treatment. Additionally, they were categorized as either normoglycemic, prediabetic or diabetic. Median follow-up time was 28 months.A total of 71 patients were selected for this study. Of this population, 57.7% were normoglycemic, 28.2% were prediabetic and 14.1% were diabetic. Diabetic patients showed the most increase in HbA1c (+1.4%). This was followed by prediabetic patients (+0.5%) and normoglycemic patients (+0.3%).Worsening glycemic control, defined as either an increase in HbA1c ≥0.5% or advancement to a higher American Diabetes Association glycemic category, was reported. Nine of 10 diabetic patients presented with worsening glycemic control. Half of the prediabetic patients had worsening control, and 44% of normoglycemic patients presented with similar results.Unfortunately, diabetic patients had the lowest rate of recovery back to baseline glycemic measurements (33.3%). Prediabetic patients had a higher success rate at 75%, but normoglycemic patients presented with a low result as well (35.3%). Initiation or escalation of medication was deemed necessary for 60% of diabetic patients, 30% of prediabetic patients and 2.4% of normoglycemic patients.“Although some patients recover to their baseline glycemic status,” mentioned the researchers in their paper, “recovery is variable and may be incomplete, especially for those with baseline diabetes, who often require ongoing pharmacologic therapy. These findings reinforce the need for systematic glycemic risk assessment prior to teprotumumab initiation and support routine HbA1c monitoring throughout and after treatment completion to proactively manage these metabolic complications.”Click here for the journal source. Yoon MK, Lee NG, Ha SK, et al. Longitudinal glycemic outcomes in patients with thyroid eye disease treated with teprotumumab. Ophthalmic Plast Reconstr Surg 2026;42:397-403. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.