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Treating Thyroid Associated Ophthalmopathy in Pediatric Patients

Thyroid associated ophthalmopathy (TAO) is a common extra-thyroid clinical manifestation of Graves’ disease. It is an inflammatory disease of the eye and orbital tissues. Up to one-third of pediatric Graves’ disease patients could be diagnosed with TAO. The symptoms can be variable with remissions a...

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Autores principales: Dong, Tianyu, Fu, Zhujun, Wang, Xu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273847/
https://www.ncbi.nlm.nih.gov/pubmed/35837312
http://dx.doi.org/10.3389/fendo.2022.900204
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author Dong, Tianyu
Fu, Zhujun
Wang, Xu
author_facet Dong, Tianyu
Fu, Zhujun
Wang, Xu
author_sort Dong, Tianyu
collection PubMed
description Thyroid associated ophthalmopathy (TAO) is a common extra-thyroid clinical manifestation of Graves’ disease. It is an inflammatory disease of the eye and orbital tissues. Up to one-third of pediatric Graves’ disease patients could be diagnosed with TAO. The symptoms can be variable with remissions and exacerbations of pediatric Graves’ disease, which has negative effects on the quality of life in children. Teprotumumab is a fully human IgG1κ type monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), and was approved for the treatment of TAO as a “breakthrough therapy” by the FDA in 2020. Nevertheless, the safety and effectiveness have not been established in pediatric patients. IGF-1R plays an important role in human development, which raises concerns of developmental toxicity. As presented in the pharmacology review report, juvenile monkeys were tested in two separate repeated-dose toxicity studies and no NOAEL was identified. Teprotumumab affected the growth, thymus, spleen and decreased the bone growth. Younger animals seemed to be more sensitive to the effects on normal growth and normal thymus. Hearing impairment posed additional risk to the potential pediatric use, especially for school-age children. Considering the nature of the target, Teprotumumab should not be used empirically in children. More efforts would be made for the further development of teprotumumab for pediatric use.
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spelling pubmed-92738472022-07-13 Treating Thyroid Associated Ophthalmopathy in Pediatric Patients Dong, Tianyu Fu, Zhujun Wang, Xu Front Endocrinol (Lausanne) Endocrinology Thyroid associated ophthalmopathy (TAO) is a common extra-thyroid clinical manifestation of Graves’ disease. It is an inflammatory disease of the eye and orbital tissues. Up to one-third of pediatric Graves’ disease patients could be diagnosed with TAO. The symptoms can be variable with remissions and exacerbations of pediatric Graves’ disease, which has negative effects on the quality of life in children. Teprotumumab is a fully human IgG1κ type monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), and was approved for the treatment of TAO as a “breakthrough therapy” by the FDA in 2020. Nevertheless, the safety and effectiveness have not been established in pediatric patients. IGF-1R plays an important role in human development, which raises concerns of developmental toxicity. As presented in the pharmacology review report, juvenile monkeys were tested in two separate repeated-dose toxicity studies and no NOAEL was identified. Teprotumumab affected the growth, thymus, spleen and decreased the bone growth. Younger animals seemed to be more sensitive to the effects on normal growth and normal thymus. Hearing impairment posed additional risk to the potential pediatric use, especially for school-age children. Considering the nature of the target, Teprotumumab should not be used empirically in children. More efforts would be made for the further development of teprotumumab for pediatric use. Frontiers Media S.A. 2022-06-28 /pmc/articles/PMC9273847/ /pubmed/35837312 http://dx.doi.org/10.3389/fendo.2022.900204 Text en Copyright © 2022 Dong, Fu and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Dong, Tianyu
Fu, Zhujun
Wang, Xu
Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title_full Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title_fullStr Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title_full_unstemmed Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title_short Treating Thyroid Associated Ophthalmopathy in Pediatric Patients
title_sort treating thyroid associated ophthalmopathy in pediatric patients
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273847/
https://www.ncbi.nlm.nih.gov/pubmed/35837312
http://dx.doi.org/10.3389/fendo.2022.900204
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