Every year, doctors diagnose almost 1 million Americans with thyroid eye disease, a condition that occurs when your body’s immune system mistakenly attacks the tissues and muscles around your eyes. About 90% of people with thyroid eye disease also have Graves’ disease, in which your immune system attacks your thyroid gland; that’s why thyroid eye disease is also sometimes referred to as Graves’ eye disease.
The most common symptoms of thyroid eye disease include double vision, bulging eyes, eyelid swelling, tightening eye lids, dry eye, and a feeling of grittiness or irritation in the eyes. In severe cases, symptoms may include scars in your cornea, decreased eye movement, an inability to close your eyelids, and even vision loss.
Until recently, mainstays in thyroid eye disease treatment focused on reducing inflammation and preserving sight as much as possible. But a new thyroid eye disease treatment shows tremendous promise in improving certain symptoms and quality of life. If you have thyroid eye disease, your doctor can help you determine whether this new treatment advancement may be the right move for you.
A Breakthrough Medication
Recently, doctors discovered a new drug, teprotumumab, may be the best option for reducing the severity of thyroid eye disease symptoms. This drug, originally intended to help cancer patients, belongs to a new class of drugs called monoclonal antibodies. Monoclonal antibodies, which are produced in a laboratory, work similarly to your own immune system cells. These types of drugs function in a variety of ways, such as blocking molecules that turn off your immune system.
In people living with thyroid eye disease, autoimmune cells that mistakenly attack the healthy thyroid gland also attack soft tissues within the eye socket resulting in intense inflammation. Teprotumumab helps correct the symptoms of thyroid eye disease by blocking this inflammation. This, in turn, leads to decreased symptoms. In one study, 43% of patients experienced a significant decrease in the severity of their symptoms, including bulging eyes, after only six weeks of treatment. After 24 weeks, 69% of patients receiving teprotumumab showed marked improvements in their symptoms. And side effects are minimal–the only adverse effects reported in the trials were higher blood sugar in people with diabetes.
Currently, teprotumumab is an experimental treatment. However, thanks to its dramatic effects, the U.S. Food and Drug Administration (FDA) plans to evaluate this medication quickly. Experts expect teprotumumab to enter the market in early 2020, making it the first FDA-approved treatment for active thyroid eye disease symptoms.
Teprotumumab shows great promise as an effective therapy for many of the symptoms of thyroid eye disease. This new treatment, which harnesses the power of your own immune system, may be your best option, especially if your symptoms are severe.
If teprotumumab isn’t the right fit for you, your doctor can recommend more traditional treatments. The standard treatment for thyroid eye disease involves a combination of therapies intended to manage symptoms and preserve your vision. First of all, it’s imperative to stop smoking, as smokers with Graves’ disease are seven times more likely to develop thyroid eye disease. Plus, smoking decreases the effectiveness of many treatments used for thyroid eye disease. When it comes to medication, not everyone requires treatment, but if you’re experiencing symptoms,, doctors often prescribe oral steroids to help reduce inflammation and swelling around the eyes. Other symptoms, such as eye irritation, are managed with lubricating drops. In some cases, radiation therapy is delivered to help reduce swelling around the eyes. If necessary, surgery is performed to decompress the crowded eye socket, preserving vision.
But drugs, radiation, and surgical interventions don’t always improve symptoms, and in some cases, symptoms improve and then return again months or years after your initial treatment. Since outcomes are generally uncertain among people living with thyroid eye disease, finding alternative treatments has become a research priority. Fortunately, with the introduction of teprotumumab, patients have a new and effective treatment option, with more like it coming down the pipeline.