Teprotumumab-associated hearing-related adverse events

ABSTRACT

This study aims to provide a review of the existing literature on teprotumumab (Tepezza)-associated hearing-related adverse effects. A review of PubMed and Embase was conducted using keywords “teprotumumab,” “tepezza,” “hearing disorder[s],” “hearing loss,” and “ototoxicity.” These search results were filtered to include all clinical trials, observational studies, case reports, and case series relevant to the topic of teprotumumab-associated hearing disorders. Data collection from the 15 included studies consisted of: sample size, number and percentage of hearing disorders reported, types of hearing disorders, remission rates, timeline of symptom onset, predisposing risk factors, suggested screening guidelines, and treatment proposals. Teprotumumab-associated hearing disorders are reported in 7–81.5% (median 12%) of clinical study participants. Symptoms described include sensorineural hearing loss (SNHL), hypoacusis, autophony, ear fullness/pressure/plugging, patulous eustachian tube, and tinnitus. Most symptoms improve with discontinuation of teprotumumab, but some symptoms persist after completion of treatment, most commonly SNHL. Symptoms have been reported occurring 3–37 (median 8.4) weeks after treatment initiation, with the majority reported 6 weeks after treatment initiation. Additional prospective studies are needed to clarify how frequently teprotumumab causes ototoxicity. There remains a need for both standardized audiologic screening guidelines and treatment for patients in whom ototoxicity persists post-treatment.

Keywords: teprotumumab, tepezza, hearing disorder[s], hearing loss, ototoxicity