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Hearing abnormalities in patients treated with teprotumumab

The introduction of teprotumumab for the treatment of thyroid eye disease has dramatically improved management of this life-changing condition; however, clinical trials and experience in the clinic have revealed associated hearing abnormalities.

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Fig. 1: Localization of IGF-1R-mediated otologic actions.


  1. Smith, T. J. & Hegedüs, L. Graves’ disease. N. Engl. J. Med. 375, 1552–1565 (2016).

    Article  PubMed  Google Scholar 

  2. Smith, T. J. et al. Teprotumumab for thyroid-associated ophthalmopathy. N. Engl. J. Med. 376, 1748–1761 (2017).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Douglas, R. S. et al. Teprotumumab for the treatment of active thyroid eye disease. N. Engl. J. Med. 382, 341–352 (2020).

    Article  CAS  PubMed  Google Scholar 

  4. Fernando, R., Caldera, O. & Smith, T. J. Therapeutic IGF-I receptor inhibition alters fibrocyte immune phenotype in thyroid-associated ophthalmopathy. Proc. Natl Acad. Sci. USA 118, e2114244118 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Douglas, R. S. et al. Efficacy and safety of teprotumumab in patients with thyroid eye disease of long duration and low disease activity. J. Clin. Endocrinol. Metab. 109, 25–35 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gao, L. & Nakagawa, T. Insulin-like growth factor 1: role in the auditory system and therapeutic potential in otology. Curr. Opin. Otolaryngol. Head Neck Surg. 28, 286–290 (2020).

    Article  PubMed  Google Scholar 

  7. Kiely, K. M., Gopinath, B., Mitchell, P., Browning, C. J. & Anstey, K. J. Evaluating a dichotomized measure of self-reported hearing loss against gold standard audiometry: prevalence estimates and age bias in a pooled national data set. J. Aging Health 24, 439–458 (2012).

    Article  PubMed  Google Scholar 

  8. Bance, M., Tysome, J. R. & Smith, M. E. Patulous Eustachian tube (PET), a practical overview. World J. Otorhinolaryngol. Head Neck Surg. 5, 137–142 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tran, Y. et al. Establishing multifactorial risk factors for adult-onset hearing loss: A systematic review with topic modelling and synthesis of epidemiological evidence. Prev. Med. 180, 107882 (2024).

    Article  PubMed  Google Scholar 

  10. Douglas, R. S. et al. A prospective study examining audiometry outcomes following teprotumumab treatment for thyroid eye disease. Thyroid 34, 134–137 (2024).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Terry J. Smith.

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Competing interests

J.A.B. is a consultant for Amgen. D.O.K. is a consultant for Amgen, Immunovant and Lassen Therapeutics. T.J.S. has issued patents for targeting IGF-IR as a therapy for autoimmune diseases, including TED, which are held by Lundquist Institute/UCLA and University of Michigan. T.J.S. is a consultant for Amgen, Viridian Therapeutics, Lundbeck, Argenx, Lassen Therapeutics and Minghui Pharmaceuticals.

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Brant, J.A., Kikkawa, D.O. & Smith, T.J. Hearing abnormalities in patients treated with teprotumumab. Nat Rev Endocrinol 20, 381–382 (2024).

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