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Thyroid eye disease (TED) is an autoimmune condition that can cause significant impact on quality of life due to its potentially debilitating effects on visual function and cosmesis (Bahn RS. N Engl J Med 362(8):726–738, 2010). Previously, traditional medical therapy for TED included intravenous and oral corticosteroids, orbital radiation, and non-steroidal immunosuppressives such as mycophenolate (Bartalena L, Kahaly GJ, Baldeschi L, et al. Eur J Endocrinol 185(4):G43–G67, 2021; Moledina M, Damato EM, Lee V. Eye (Lond) 38(8):1425–1437, 2024). Unfortunately, none of the conventional medical therapy has been able to achieve optimal outcomes for those affected by thyroid eye disease due to variable responses and notable rates of relapse and treatment failure (Patel P, Khandji J, Kazim M. Ophthalmic Plast Reconstr Surg 31(6):445–448, 2015). Immunobiologic therapy has been gaining increasing interest in the treatment of thyroid eye disease as our understanding of the pathophysiology of thyroid eye disease continues to improve. These genetically engineered monoclonal antibodies have become established treatments of other rheumatologic inflammatory disorders and may offer improved efficacy and safety profiles in the treatment of TED as they work via selective targeting (Salvi M, Vannucchi G, Campi I, Curro N, Beck-Peccoz P. Ann Endocrinol (Paris) 69(2):153–156, 2008; Bartalena L, Lai A, Compri E, Marcocci C, Tanda ML. Ophthalmic Plast Reconstr Surg 24(4):251–256, 2008). Some targets that have been utilized in the treatment of TED include blockage of the Insulin Growth Factor Receptor, B-cell depletion, inhibition of cytokines, and blockage of the Thyroid Stimulating Hormone receptor (TSHR) (Silkiss RZ. Ophthalmic Plast Reconstr Surg 40(1):116, 2024; Ferrari SM, Fallahi P, Elia G, et al. Best Pract Res Clin Endocrinol Metab 34(1):101366, 2020). Currently, there is only one immunobiologic that is approved by the United States Food and Drug Administration (FDA) in the clinical treatment of TED. Herein, we review the current literature on immunobiologics that have been utilized in the treatment of TED.

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Biologics in Thyroid Eye Disease

  • 章节

  • 出版模式：

    开放获取

  • 发表日期：

    2026年

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  • Ying Chen,
  • Erin Shriver,
  • Sara Tullis Wester

摘要

Thyroid eye disease (TED) is an autoimmune condition that can cause significant impact on quality of life due to its potentially debilitating effects on visual function and cosmesis (Bahn RS. N Engl J Med 362(8):726–738, 2010). Previously, traditional medical therapy for TED included intravenous and oral corticosteroids, orbital radiation, and non-steroidal immunosuppressives such as mycophenolate (Bartalena L, Kahaly GJ, Baldeschi L, et al. Eur J Endocrinol 185(4):G43–G67, 2021; Moledina M, Damato EM, Lee V. Eye (Lond) 38(8):1425–1437, 2024). Unfortunately, none of the conventional medical therapy has been able to achieve optimal outcomes for those affected by thyroid eye disease due to variable responses and notable rates of relapse and treatment failure (Patel P, Khandji J, Kazim M. Ophthalmic Plast Reconstr Surg 31(6):445–448, 2015). Immunobiologic therapy has been gaining increasing interest in the treatment of thyroid eye disease as our understanding of the pathophysiology of thyroid eye disease continues to improve. These genetically engineered monoclonal antibodies have become established treatments of other rheumatologic inflammatory disorders and may offer improved efficacy and safety profiles in the treatment of TED as they work via selective targeting (Salvi M, Vannucchi G, Campi I, Curro N, Beck-Peccoz P. Ann Endocrinol (Paris) 69(2):153–156, 2008; Bartalena L, Lai A, Compri E, Marcocci C, Tanda ML. Ophthalmic Plast Reconstr Surg 24(4):251–256, 2008). Some targets that have been utilized in the treatment of TED include blockage of the Insulin Growth Factor Receptor, B-cell depletion, inhibition of cytokines, and blockage of the Thyroid Stimulating Hormone receptor (TSHR) (Silkiss RZ. Ophthalmic Plast Reconstr Surg 40(1):116, 2024; Ferrari SM, Fallahi P, Elia G, et al. Best Pract Res Clin Endocrinol Metab 34(1):101366, 2020). Currently, there is only one immunobiologic that is approved by the United States Food and Drug Administration (FDA) in the clinical treatment of TED. Herein, we review the current literature on immunobiologics that have been utilized in the treatment of TED.