Thyroid Eye Disease

Living with Thyroid Eye Disease and the Impact of Tepezza

Thyroid Eye Disease, or TED, can be a life-altering condition marked by bulging eyes, vision problems, and significant discomfort. For many, the recent emergence of Tepezza, a new treatment option, offered a beacon of hope. 

However, controversy has arisen surrounding the treatment, with lawsuits alleging serious side effects. This article delves into the complexities of living with TED. We’ll explore the potential of Tepezza, while also acknowledging the ongoing legal battles and the uncertainty it creates for patients.

Understanding Thyroid Eye Disease

TED is an autoimmune disorder that attacks the tissues around your eyes. This inflammation can progressively damage muscles, connective tissues, and fat behind the eye.

The National Organization for Rare Disorders outlines the key symptoms of TED‘s active phase, which can last for months or even years. These include pain, a gritty feeling in the eyes, swollen or misaligned eyelids, watery eyes, bulging eyes, and double vision.

While the inflammation eventually subsides in an inactive phase, some problems like double vision and bulging eyes may persist. In severe cases, vision loss can occur, and some people experience lasting cosmetic changes or significant disability that can greatly impact their daily lives.

Treatment Landscape Before Tepezza

Before Tepezza’s arrival, managing TED relied on a combination of therapies, each with its strengths and limitations.

For mild cases, artificial tears offered lubrication and relief from irritation and dryness. These come in various forms: drops, gels, and ointments.

When inflammation escalated, steroids became the primary weapon. Oral or intravenous steroids could help reduce double vision by enabling inflamed eye muscles to move more freely. 

Additionally, they could lessen redness and swelling in the eyes and eyelids, and even restore vision in severe cases. However, steroid effectiveness in reducing bulging eyes was limited.

Immunosuppressant medications, sometimes used alongside steroids, aimed to suppress the overactive immune response fueling TED. While they could aid in controlling inflammation and preventing relapse, they come with potential side effects requiring careful monitoring.

Finally, in severe cases where inflammation subsided but problems like double vision persisted, rehabilitative surgery offered an option. Decompression surgery could create more space behind the eye to relieve pressure on nerves and bulging eyeballs. Alternatively, eye muscle surgery could address persistent double vision, and eyelid surgery could aim to protect exposed eyes and improve appearance.

The Rise of Tepezza

Tepezza, approved by the FDA in 2020, emerged as a revolutionary treatment for TED. Unlike traditional therapies that broadly targeted inflammation, the drug offered a more precise approach.

HealthCentral explains how the treatment works. Behind the eye, cells have receptors for a growth factor called IGF-1. In TED, these receptors are mistakenly activated by the immune system, triggering inflammation and swelling of surrounding tissues. This leads to the characteristic bulging eyes and other symptoms.

Tepezza acts like a gatekeeper, binding to the IGF-1 receptors and blocking them in the “off” position. Essentially, it flips the switch, preventing the inflammatory process from starting. This targeted approach offers promising benefits including:

  • Reduced eye bulging which can significantly improve appearance and potentially relieve pressure on the optic nerve.
  • Improved vision, as swelling behind the eye can obstruct vision clarity.

The medication is administered through eight infusions, spaced three weeks apart, for a total treatment time of around five months. While the initial infusions take longer, 

subsequent ones can be completed more quickly if tolerated well.

The Shadow of Side Effects

The promise of the treatment was dimmed by the emergence of concerning side effects. Many patients reported experiencing permanent hearing loss and tinnitus (ringing in the ears) after undergoing Tepezza infusions. This unexpected complication casts a shadow over the drug’s effectiveness.

The Tepezza lawsuit against its manufacturer, Horizon Therapeutics, alleges a lack of transparency regarding potential side effects. According to filings, neither patients nor their doctors were adequately informed about the risk of permanent hearing loss. 

Moreover, the baseline audiology testing, crucial for monitoring hearing health, was not recommended before or during treatment.

The Tepezza Multidistrict Litigation (MDL) has grown considerably, with a surge of new cases filed by individuals experiencing hearing loss and other adverse effects. This legal battle highlights the growing concerns surrounding the drug safety profile.

According to TorHoerman Law, the once-promising story of Tepezza is now clouded by controversy. The legal battle will determine the extent of its risks and the manufacturer’s accountability, leaving TED patients navigating a complex landscape of hope and uncertainty.

FDA Response to the Controversy

Regulatory agencies, notably the U.S. Food and Drug Administration (FDA), have responded to the controversies surrounding the treatment. 

According to, in July 2023, the FDA issued a revised version of the Tepezza prescribing information guide. This update incorporated warnings about severe and permanent hearing loss reported by users. 

It acknowledges the need for heightened awareness of potential adverse effects and underscores the importance of proactive monitoring by healthcare providers. The new 

label advises doctors to assess patients’ hearing before, during, and after infusions to mitigate the risk of permanent ear damage. 

Frequently Asked Questions

What should be avoided with thyroid eye disease?

With TED, it’s crucial to avoid smoking, as it can worsen symptoms and increase the risk of complications. Additionally, exposure to dry or windy conditions and excessive eye rubbing should be minimized to prevent aggravating inflammation and discomfort in the eyes.

What are the side effects of Tepezza?

Common side effects of the drug include muscle cramps, diarrhea, nausea, fatigue, hair loss, and high blood sugar. Additionally, hearing problems, taste changes, headaches, dry skin, weight loss, nail issues, and menstruation changes may occur. These effects should be monitored and discussed with a healthcare provider promptly.

Are Tepezza side effects permanent?

Tepezza side effects can vary in severity and duration. While some may resolve over time or with treatment cessation, others, such as hearing problems or hair loss, may be permanent. Promptly discussing concerns with a healthcare provider is crucial for appropriate management and monitoring of potential long-term effects.

In conclusion, living with TED presents a unique set of challenges. While Tepezza offered hope, the emergence of hearing loss and other side effects cast a shadow of uncertainty. The ongoing legal battles highlight the importance of transparency and prioritizing patient safety in the development and marketing of new medications.

The path forward for TED patients remains uncertain. While Tepezza offers potential benefits, it comes with a risk-reward equation that requires careful consideration. We can expect ongoing research on both the drug’s safety and the development of alternative treatments.

Ultimately, the best course of action lies in open communication with your doctor. By staying informed about TED, Tepezza’s evolving landscape, and potential treatment options, you can play an active role in managing your condition.

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