Don't get left behind! The modernized is coming. Check it out now.
Say goodbye to!
The new site is coming soon - go to the modernized
Working… Menu

A Study Evaluating TEPEZZA® Treatment in Patients With Chronic (Inactive) Thyroid Eye Disease

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04583735
Recruitment Status : Active, not recruiting
First Posted : October 12, 2020
Last Update Posted : April 11, 2023
Information provided by (Responsible Party):
Horizon Pharma USA, Inc. ( Horizon Therapeutics USA, Inc. )

Brief Summary:
The overall objective is to investigate the efficacy, safety and tolerability of TEPEZZA® in participants with chronic (inactive) TED (thyroid eye disease). Approximately 57 participants will be enrolled. There will be a treatment period (through Week 24) and a follow up period (where TEPEZZA will not be infused).

Condition or disease Intervention/treatment Phase
Thyroid Eye Disease Chronic (Inactive) Thyroid Eye Disease Biological: TEPEZZA Drug: Placebo Phase 4

Detailed Description:

This is a randomized, double-masked, placebo-controlled, parallel-group, multicenter trial. Participants will be screened for the trial within 4 weeks prior to Baseline (Day 1). Approximately 57 participants who meet the trial eligibility criteria will be randomized on Day 1 in a 2:1 ratio to receive 8 infusions of TEPEZZA or placebo once every 3 weeks.

All participants will enter a 24-week double-masked Treatment Period, during which trial drug will be infused on Day 1 (Baseline) and Weeks 3, 6, 9, 12, 15, 18 and 21 (with a final visit at Week 24 of the 24-week Treatment Period). At the end of the double-masked Treatment Period (Week 24), all patients will be assessed for treatment response. Non-responders may choose to receive 8 infusions of TEPEZZA in an open-label fashion q3W at Weeks 24, 27, 30, 33, 36, 39, 42 and 45.

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 62 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 4, Randomized, Double-masked, Placebo-controlled, Multicenter Trial to Evaluate the Efficacy and Safety of TEPEZZA® in Treating Patients With Chronic (Inactive) Thyroid Eye Disease
Actual Study Start Date : September 2, 2021
Actual Primary Completion Date : March 16, 2023
Estimated Study Completion Date : October 16, 2023

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
8 infusions of TEPEZZA (10 mg/kg for the first infusion and 20 mg/kg for the remaining 7 infusions) with a final visit at Week 24 (Treatment Period)
Biological: TEPEZZA
TEPEZZA is a fully human anti-IGF-1R mAb.TEPEZZA will be provided in single-dose 20mL glass vials as a freeze-dried powder.Each vial of TEPEZZA must be reconstituted with 10 mL of sterile water for injection. Reconstituted TEPEZZA solution must be further diluted in 0.9% (w/v) sodium chloride (NaCl) solution prior to administration.TEPEZZA will be administered in 100 mL or 250 mL infusion bags (100 mL infusion bags for doses up to 1800 mg and 250 mL infusion bags for doses > 1800 mg).
Other Names:
  • teprotumumab-trbw
  • HZN-001

Placebo Comparator: Placebo
Placebo once every 3 weeks
Drug: Placebo
Placebo (normal saline, 0.9% NaCl) solution will be administered in 100 mL or 250 mL infusion bags per weight based dosing volumes once every 3 weeks
Other Name: sodium chloride

Primary Outcome Measures :
  1. Change from Baseline at Week 24 in proptosis in the study eye [ Time Frame: Week 24 ]
    Hertel exophthalmometer is used to measure the prominence of the eye. It measures the anterior projection of the eye from the lateral orbital rim to the cornea (proptosis).

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Written informed consent.
  2. Male or female at least 18 years old at Screening.
  3. Initial diagnosis of TED ≥2 years but <10 years prior to Screening. Clinical diagnosis of stable, chronic (inactive) TED, as determined by participant medical records indicating a Clinical Activity Score (CAS) ≤1 in both eyes for at least 1 year prior to Screening or all of the following:

    1. no progression in proptosis for at least 1 year prior to Screening
    2. if participant has history of diplopia due to TED, no progression in diplopia for at least 1 year prior to Screening
    3. no new inflammatory TED symptoms for at least 1 year prior to Screening
  4. CAS ≤1 at the Screening and Baseline Visits.
  5. Proptosis ≥3-mm increase from participant's Baseline (prior to diagnosis of TED), as estimated by treating physician and/or proptosis ≥3 mm above normal for race and gender.
  6. Participants must be euthyroid with the participant's Baseline disease under control or have mild hypo- or hyperthyroidism (defined as free thyroxine and free triiodothyronine levels <50% above or below the normal limits) at Screening. Every effort should be made to correct the mild hypo- or hyperthyroidism promptly and to maintain the euthyroid state for the full duration of the trial.
  7. Does not require immediate surgical ophthalmological intervention and is not planning corrective surgery/irradiation during the course of the trial.
  8. Diabetic participants must have HbA1c ≤8.0% at Screening.
  9. Participants with a history of inflammatory bowel disease, ulcerative colitis or Crohn's disease must be in clinical remission for at least 3 months, with no history of bowel surgery within 6 months prior to screening and no planned surgery during the trial. Concomitant stable therapies for inflammatory bowel disease without modifications in the 3 months prior to Screening are allowed.
  10. Women of childbearing potential (including those with an onset of menopause <2 years prior to Screening, non-therapy-induced amenorrhea for <12 months prior to Screening, or not surgically sterile [absence of ovaries and/or uterus]) must have a negative serum pregnancy test at Screening and negative urine pregnancy tests at all protocol-specified time points (i.e., prior to each dose and throughout participant's participation); participants who are sexually active with a non-vasectomized male partner must agree to use 2 reliable forms of contraception during the trial, 1 of which is recommended to be hormonal, such as an oral contraceptive. Hormonal contraception must be started at least 1 full cycle prior to Baseline and continue for 180 days after the last dose of trial drug. Highly effective contraceptive methods (failure rate <1% per year), when used consistently and correctly, include implants, injectables, combination oral contraceptives, some intrauterine devices, sexual abstinence and vasectomized partner.
  11. Willing and able to comply with the prescribed treatment protocol and evaluations for the duration of the trial.

Exclusion Criteria:

  1. Decreased best-corrected visual acuity due to optic neuropathy, defined by a decrease in vision of 2 lines on the Snellen chart, new visual field defect or color defect secondary to optic nerve involvement within the last 6 months.
  2. Corneal decompensation unresponsive to medical management in the study eye
  3. Decrease in proptosis of ≥2 mm in the study eye between Screening and Baseline.
  4. Prior orbital irradiation, orbital decompression in the study eye.
  5. Prior strabismus surgery.
  6. Alanine aminotransferase or aspartate aminotransferase >3 × the upper limit of normal or estimated glomerular filtration rate ≤30 mL/min/1.73 m2 at Screening.
  7. Use of any steroid (IV, oral, steroid eye drops) for the treatment of TED or other conditions within 3 weeks prior to Screening. Steroids cannot be initiated during the trial. Exceptions include topical and inhaled steroids and steroids used to treat infusion reactions.
  8. Any treatment with rituximab (Rituxan® or MabThera®) within 12 months prior to the first infusion of trial drug or tocilizumab (Actemra® or Roactemra®) within 6 months prior to the first infusion of trial drug. Use of any other non-steroid immunosuppressive agent within 3 months prior to the first infusion of trial drug.
  9. Any previous treatment with TEPEZZA, including previous enrollment in this trial or participation in a prior teprotumumab trial.
  10. Treatment with any mAb within 3 months prior to Screening.
  11. Identified pre-existing ophthalmic disease that, in the judgment of the Investigator, would preclude trial participation or complicate interpretation of trial results.
  12. Use of an investigational agent for any condition within 60 days or 5 half-lives, whichever is longer, prior to Screening or anticipated use during the course of the trial.
  13. Malignant condition in the past 12 months (except successfully treated basal/squamous cell carcinoma of the skin or cervical cancer in situ).
  14. Pregnant or lactating women.
  15. Current drug or alcohol abuse or history of either within the previous 2 years, in the opinion of the Investigator or as reported by the participant.
  16. Known hypersensitivity to any of the components of TEPEZZA or prior hypersensitivity reactions to mAbs.
  17. Poorly controlled human immunodeficiency virus infection or untreated or positive viral load for hepatitis C or hepatitis B infections.
  18. Any other condition that, in the opinion of the Investigator, would preclude inclusion in the trial.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04583735

Layout table for location information
United States, California
The Private Practice of Raymond Douglas
Beverly Hills, California, United States, 90210
Perlman Medical Offices / UCSD
La Jolla, California, United States, 92037
MACRO Trials
Los Angeles, California, United States, 90048
United States, Colorado
Univ of Colorado Dept of Ophthalmology
Aurora, Colorado, United States, 80045
United States, Florida
Bascom Palmer Eye Institute / Univ of Miami
Miami, Florida, United States, 33136
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, Missouri
Washington University
Saint Louis, Missouri, United States, 63108
United States, Nevada
Las Vegas Endocrinology
Las Vegas, Nevada, United States, 89074
United States, South Carolina
Endocrinology Specialists & Thyroid Center
Greenville, South Carolina, United States, 29605
United States, Tennessee
Hamilton Eye Institute / U Tennessee
Memphis, Tennessee, United States, 38163
United States, Texas
Neuro-Eye Clinical Trials
Houston, Texas, United States, 77401
United States, Wisconsin
Medical College of Wisconsin
Milwaukee, Wisconsin, United States, 52336
Sponsors and Collaborators
Horizon Therapeutics USA, Inc.
Layout table for investigator information
Study Director: Medical Director Horizon Therapeutics USA, Inc.
Additional Information:
Layout table for additonal information
Responsible Party: Horizon Therapeutics USA, Inc. Identifier: NCT04583735    
Other Study ID Numbers: HZNP-TEP-403
First Posted: October 12, 2020    Key Record Dates
Last Update Posted: April 11, 2023
Last Verified: April 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Horizon Pharma USA, Inc. ( Horizon Therapeutics USA, Inc. ):
Additional relevant MeSH terms:
Layout table for MeSH terms
Eye Diseases
Graves Ophthalmopathy
Thyroid Diseases
Endocrine System Diseases
Eye Diseases, Hereditary
Graves Disease
Orbital Diseases
Genetic Diseases, Inborn
Autoimmune Diseases
Immune System Diseases