Some patients treated with teprotumumab (Tepezza) for TED may experience hearing loss as an adverse effect. Photo: Bobby Saenz, OD, MS. Click image to enlarge.

Researchers recently reported hearing-related side effects with teprotumumab use in a small case series of 27 patients, recommending audiometry with patulous eustachian tube (PET) testing at baseline.

In the prospective case series, 81.5% of patients developed new subjective otologic symptoms after an average of 3.8 infusions of teprotumumab. At follow-up after the final infusion, 100% of patients with tinnitus, 90.9% with ear plugging/fullness, 83.3% with autophony and 45.5% with subjective hearing loss or decreased word comprehension had symptom resolution.

The researchers noted that, of the six patients who underwent baseline and post-treatment audiometry, five developed teprotumumab-related sensorineural hearing loss (three of whom had persistent subject hearing loss at final follow-up) and one developed PET. The researchers reported that history of hearing loss was a risk factor for the drug-related hearing loss. Though most patients weren’t functionally impacted by their symptoms, four wore hearing aids during the study and three discontinued therapy.

“Hearing dysfunction has been described as a side effect in 10% of patients in the randomized clinical trials [of teprotumumab],” the researcher wrote in their paper. “Our results demonstrate a much higher percentage of teprotumumab-treated thyroid eye disease patients with new otologic symptoms than previously reported […]. Patients with baseline hearing loss should be counseled on this potential risk and strongly advised to undergo baseline audiometric testing with frequent monitoring.”