Tepezza (teprotumumab-trbw) is the first FDA-approved medication specifically designed to treat thyroid eye disease (TED), also called Graves' ophthalmopathy. Endocrine & Diabetes Plus is proud to offer Tepezza consultation and coordination for patients with TED.
👁️ Tepezza Specialist Care: Our endocrinologists evaluate and co-manage thyroid eye disease and coordinate Tepezza infusion therapy for eligible patients. Call 832-968-7003 or book online to schedule an evaluation.
What Is Thyroid Eye Disease?
Thyroid eye disease (TED) is an autoimmune condition most commonly associated with Graves' disease (hyperthyroidism). In TED, the immune system attacks the tissues behind the eyes, causing:
- Proptosis (bulging eyes / exophthalmos)
- Double vision (diplopia)
- Eye pain or pressure, especially with eye movement
- Redness and swelling of the eyelids and conjunctiva
- Light sensitivity
- In severe cases, vision loss from optic nerve compression
TED can occur even in patients with normal thyroid function, or in those with Hashimoto's thyroiditis. It follows an active inflammatory phase (typically 1–3 years) and then a stable phase. Tepezza works best during the active phase.
How Does Tepezza Work?
Tepezza is a fully human monoclonal antibody that targets and blocks the IGF-1R (insulin-like growth factor-1 receptor), which plays a central role in the immune cascade driving TED. By blocking IGF-1R, Tepezza reduces inflammation and the expansion of muscle and connective tissue behind the eye.
Clinical Evidence
In pivotal clinical trials, Tepezza demonstrated remarkable results compared to placebo:
- Proptosis reduction: ~83% of patients had clinically meaningful reduction in eye bulging vs. ~10% with placebo
- Clinical Activity Score improvement: 78% response rate in active TED
- Double vision improvement: significant reduction in diplopia
- Quality of life: meaningful improvements in patient-reported visual function and appearance
Some patients achieve near-complete reversal of proptosis — a result previously only possible with surgical orbital decompression.
Treatment Protocol
Tepezza is administered as an intravenous (IV) infusion:
- Frequency: Once every 3 weeks
- Total course: 8 infusions (approximately 24 weeks)
- Setting: Infusion center (coordinated through our office)
- Duration per session: ~90 minutes for the first infusion, 60 minutes thereafter
Side Effects
Tepezza is generally well tolerated. The most commonly reported side effects include:
- Hyperglycemia (high blood sugar) — especially in patients with pre-existing diabetes. Blood sugar monitoring is essential during treatment
- Muscle cramps or spasms
- Nausea
- Hair loss (usually temporary)
- Fatigue
- Hearing changes — a small percentage of patients report new or worsened hearing loss or tinnitus; discuss with your doctor if this occurs
- Infusion reactions (managed with premedication)
🩺 Diabetes & Tepezza: Because Tepezza can raise blood sugar, patients with diabetes require close glucose monitoring during the treatment course. Our endocrinologists are uniquely qualified to manage this overlap safely.
Who Is a Candidate?
Tepezza is FDA-approved for adults with active thyroid eye disease. Ideal candidates typically have:
- Active TED (clinical activity score ≥4) confirmed by an ophthalmologist or endocrinologist
- Symptoms within the active inflammatory phase (generally within 1–2 years of onset)
- Moderate-to-severe TED causing significant proptosis, diplopia, or functional impairment
Tepezza is not recommended during pregnancy and requires careful consideration in patients with inflammatory bowel disease.
Insurance & Access
Tepezza is covered by most major insurance plans for FDA-approved indications, including Medicare and Medicaid in many states. Horizon Therapeutics offers a patient support program (TOGETHER with TEPEZZA) for prior authorization assistance and co-pay support. Our team helps navigate the insurance and prior authorization process.
Key Takeaways
- Tepezza is the only FDA-approved treatment specifically for thyroid eye disease (TED)
- Works by blocking IGF-1R to reduce the immune-driven inflammation behind the eyes
- 8 infusions over 24 weeks; most effective in the active phase of TED
- Can significantly reduce proptosis, double vision, and pain
- Blood sugar monitoring is important — especially for patients with diabetes
- Our endocrinologists coordinate evaluation, monitoring, and infusion referral
Our Team Can Help with Your Medications
All five of our providers prescribe and manage endocrine medications. Book with any member of our team:
Book an Appointment → or call 832-968-7003