Irina Belinsky1, Francis X Creighton2, Nicholas Mahoney3, Carisa K Petris4, Alison B Callahan5, Ashley A Campbell3, Michael Kazim6, H B Harold Lee7, Michael K Yoon8, Lora R Dagi Glass6. 1. Department of Ophthalmology, New York University Langone Health, New York, New York. 2. Department of Otolaryngology, Johns Hopkins, Baltimore, Maryland. 3. Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins, Baltimore, Maryland. 4. Department of Ophthalmology, University of Missouri, Columbia, Missouri. 5. Department of Ophthalmology, Tufts University Medical Center, Boston, Massachusetts. 6. Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York. 7. Oculofacial Plastic and Orbital Surgery, Indianapolis, Indiana. 8. Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Abstract
PURPOSE: To present a protocol for audiologic monitoring in the setting of teprotumumab treatment of thyroid eye disease, motivated by 4 cases of significant hearing loss, and review the relevant literature. METHODS: Cases of hearing loss in the setting of teprotumumab were retrospectively elicited as part of a multi-institutional focus group, including oculoplastic surgeons, a neurotologist and an endocrinologist. A literature review was performed. RESULTS: An aggregate of 4 cases of teprotumumab-associated hearing loss documented by formal audiologic testing were identified among 3 clinicians who had treated 28 patients. CONCLUSIONS: Teprotumumab may cause a spectrum of potentially irreversible hearing loss ranging from mild to severe, likely resulting from the inhibition of the insulin-like growth factor-1 and the insulin-like growth factor-1 receptor pathway. Due to the novelty of teprotumumab and the lack of a comprehensive understanding of its effect on hearing, the authors endorse prospective investigations of hearing loss in the setting of teprotumumab treatment. Until the results of such studies are available, the authors think it prudent to adopt a surveillance protocol to include an audiogram and tympanometry before, during and after infusion, and when prompted by new symptoms of hearing dysfunction.
PURPOSE: To present a protocol for audiologic monitoring in the setting of teprotumumab treatment of thyroid eye disease, motivated by 4 cases of significant hearing loss, and review the relevant literature. METHODS: Cases of hearing loss in the setting of teprotumumab were retrospectively elicited as part of a multi-institutional focus group, including oculoplastic surgeons, a neurotologist and an endocrinologist. A literature review was performed. RESULTS: An aggregate of 4 cases of teprotumumab-associated hearing loss documented by formal audiologic testing were identified among 3 clinicians who had treated 28 patients. CONCLUSIONS: Teprotumumab may cause a spectrum of potentially irreversible hearing loss ranging from mild to severe, likely resulting from the inhibition of the insulin-like growth factor-1 and the insulin-like growth factor-1 receptor pathway. Due to the novelty of teprotumumab and the lack of a comprehensive understanding of its effect on hearing, the authors endorse prospective investigations of hearing loss in the setting of teprotumumab treatment. Until the results of such studies are available, the authors think it prudent to adopt a surveillance protocol to include an audiogram and tympanometry before, during and after infusion, and when prompted by new symptoms of hearing dysfunction.
Authors: Connie M Sears; Amee D Azad; Linus Amarikwa; Brandon H Pham; Clara J Men; Daniel N Kaplan; Jocelyn Liu; Andrew R Hoffman; Austin Swanson; Jennifer Alyono; Jennifer Y Lee; Chrysoula Dosiou; Andrea L Kossler Journal: Am J Ophthalmol Date: 2022-02-25 Impact factor: 5.488
Authors: Jadwiga Furmaniak; Jane Sanders; Paul Sanders; Yang Li; Bernard Rees Smith Journal: Clin Endocrinol (Oxf) Date: 2022-02-06 Impact factor: 3.523