A New Era in the Treatment of Thyroid Eye Disease
Thyroid Eye Disease (TED), also known as Graves’ Eye Disease, is an autoimmune condition that can significantly affect both vision and quality of life. Symptoms can include eye pain, pressure, redness, swelling, double vision and the appearance of bulging eyes (proptosis). For many patients, these symptoms can be distressing and have a profound impact on day-to-day activities and confidence.
The introduction of TEPEZZA® (teprotumumab) has transformed the treatment landscape for patients with moderate-to-severe Thyroid Eye Disease. As the first targeted medical therapy specifically developed for TED, TEPEZZA offers a new option for suitable patients, with the potential to reduce inflammation, improve eye symptoms and lessen the need for more invasive surgical interventions.
Sharing Early UK Experience
Mr Hugo Henderson, Consultant Ophthalmic Surgeon and lead clinician for the TEPEZZA pathway at The London Clinic, has been at the forefront of establishing one of the UK’s early private treatment programmes for patients with Thyroid Eye Disease.
On 2 July, Mr Henderson presented the team’s early findings and practical experience at an educational meeting sponsored by Amgen, entitled:
“TEPEZZA® (teprotumumab): Real-World Experience in the UK Private Setting – Practical Pathway Setup and Early Outcomes.”
The presentation highlighted the development of a dedicated multidisciplinary pathway, the practicalities of delivering this innovative therapy in private practice and the encouraging outcomes seen in the first patients treated.
What is TEPEZZA?
TEPEZZA (teprotumumab) is a monoclonal antibody that works by blocking the insulin-like growth factor-1 receptor (IGF-1R), which plays an important role in the development of Thyroid Eye Disease.
By targeting this pathway, TEPEZZA helps to:
- Reduce inflammation around the eyes
- Improve swelling and redness
- Decrease the sensation of pressure and discomfort
- Reduce eye bulging (proptosis)
- Improve quality of life and visual function
Clinical trials and early real-world experience have demonstrated meaningful improvements in many patients with active, moderate-to-severe TED.
Why Does TEPEZZA Require a Dedicated Treatment Pathway?
Unlike many conventional treatments for TED, TEPEZZA is a highly specialised medicine that requires careful coordination between several healthcare professionals.
Delivering this treatment safely involves:
- Specialist pharmacy procurement and storage
- Infusion unit scheduling
- Comprehensive patient screening
- Ongoing monitoring throughout treatment
- Collaboration between ophthalmology, endocrinology, pharmacy and specialist nursing teams
In many ways, the logistics are similar to those used for oncology and advanced biologic therapies.
A dedicated, multidisciplinary approach is therefore essential to ensure that every patient receives the highest standard of care.
Setting Up a Safe and Effective Service
Under Mr Henderson’s leadership, The London Clinic has developed a formal Standard Operating Procedure (SOP) to provide safe, consistent and evidence-based care for patients receiving TEPEZZA.
The pathway includes:
Before Treatment
Patients undergo a thorough assessment, including:
- Review of medical history
- Assessment for diabetes or impaired glucose tolerance
- Screening for inflammatory bowel disease
- Pregnancy assessment where appropriate
- Baseline hearing assessment (audiology)
- Blood tests including glucose, HbA1c and thyroid function tests
- Measurement of weight and blood pressure
During Treatment
TEPEZZA is administered by intravenous infusion in a specialist infusion unit.
Patients are carefully monitored throughout treatment, including:
- Observation during infusions
- Blood glucose monitoring where indicated
- Monitoring for hearing changes
- Surveillance for any gastrointestinal symptoms or adverse events
After Treatment
Patients remain under observation following each infusion and receive clear guidance on who to contact should any concerns arise.
This structured approach ensures a high standard of safety and patient support throughout the treatment journey.
Early Real-World Experience
According to Amgen, more than 25,000 people in the United States have been treated with TEPEZZA, providing substantial real-world experience with the therapy. While TEPEZZA is relatively new to the UK, The London Clinic is proud to be among the first centres pioneering its introduction for eligible patients with Thyroid Eye Disease.
To date, The London Clinic has treated six adult patients with moderate-to-severe Thyroid Eye Disease within the licensed indication for TEPEZZA.
Although UK patient numbers are still small, our early experience has been encouraging. Patients have reported improvements in:
- Eye pressure and discomfort
- Soft tissue swelling
- Appearance of the eyes
- Overall quality of life
One patient described, commented:
“My eyes are doing really well, the heaviness has completely gone, and I can look up really easily now. Everything has been really great.”
These early experiences closely mirror the benefits reported in clinical studies and provide encouraging evidence that TEPEZZA can deliver meaningful improvements for appropriately selected patients in UK private practice.
TEPEZZA represents an important advance in the management of Thyroid Eye Disease and offers meaningful benefits for carefully selected patients with active, moderate-to-severe disease.
As experience with this treatment grows in the UK, continued collaboration and data collection will further refine how this therapy is delivered and help ensure patients have access to the highest standards of care.
If you have been diagnosed with Thyroid Eye Disease and would like to explore whether TEPEZZA may be suitable for you, please contact our clinic to arrange a consultation.
To find out more about TEPEZZA treatment, contact Mr Hugo Henderson’s secretary at: secretary@hugohenderson.com