ClinicalTrials.gg
CompletedNCT03298867OPTICUpdated Jul 11, 2024Results posted

Treatment of Graves' Orbitopathy (Thyroid Eye Disease) to Reduce Proptosis With Teprotumumab Infusions in a Randomized, Placebo-Controlled, Clinical Study

A Phase 3 interventional study of Teprotumumab and Placebo in Thyroid Eye Disease and Graves' Orbitopathy, sponsored by Amgen. Completed at 14 sites in 3 countries. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2024-07-11.

Sponsored by Amgen · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
83
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The overall objective is to investigate the efficacy, tolerability, and safety of teprotumumab (a fully human monoclonal antibody [mAb] inhibitor of the insulin-like growth factor-1 receptor [IGF-1R]) administered once every 3 weeks (q3W) for 21 weeks with a final assessment at Week 24, in comparison to placebo, in the treatment of participants with moderate-to-severe active thyroid eye disease (TED).

Read the detailed description

This is a randomized, double-masked, placebo-controlled, parallel-group, multicenter study. Approximately 76 participants (38/group) who meet the study eligibility criteria will be randomized on Day 1 in a 1:1 ratio (stratified by tobacco use status) to receive 8 infusions of teprotumumab or placebo q3W. All participants will enter a 24-week double-masked Treatment Period, during which study 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). All study drug dosing will be performed at the clinic under the supervision of clinic staff. On each dosing day, scheduled assessments (except for adverse event [AE] and concomitant medication use monitoring, which will be monitored throughout the clinic visit) will be completed prior to study drug dosing.

At the end of the double-masked Treatment Period (Week 24), participants who are proptosis non-responders (study eye has \< 2 mm decrease in proptosis) will be eligible to enter an open-label extension study in which participants receive 8 infusions of teprotumumab in an open-label fashion.

At Week 24, proptosis responders, as well as non-responders who choose not to enroll in the open-label extension study, will enter a 48-week Follow-Up Period, during which study drug will not be administered and clinic visits are scheduled for Weeks 28, 36, 48, 60, and 72. Participants who are considered responders at Week 24 but who meet criteria for re-treatment due to relapse during the Follow-Up Period may enroll in the open-label extension study.

Participants who complete the Week 72 Visit will be contacted 6 and 12 months later via phone or email by research staff to enquire if any treatment for TED has been received since last study contact.

Study acquired from Horizon in 2024.

02

Conditions studied

  • Thyroid Eye Disease
  • Graves' Orbitopathy

Keywords

  • Proptosis
  • Human monoclonal antibody
  • insulin-like growth factor-1 receptor
  • Thyroid-Associated Ophthalmopathy
  • Autoimmune Thyroid Disease
  • Graves' Orbitopathy
03

In context

Graves Ophthalmopathy

199 studies on the registry are indexed under Graves Ophthalmopathy; 58 are open to participants now.

This study's enrollment of 83 is above the median of 63 across 146 interventional studies indexed under Graves Ophthalmopathy.

Browse Graves Ophthalmopathy studies →

Lead sponsor

Amgen is the lead sponsor of 1,047 studies on the registry; 52 are open to participants now.

Of its 246 completed or terminated interventional studies of FDA-regulated products, 166 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Written .
  2. Male or female participant between the ages of 18 and 80 years, inclusive, at Screening.
  3. Clinical diagnosis of Graves' disease associated with active TED with a Clinical Activity Score (CAS) ≥ 4 (on the 7-item scale) for the most severely affected eye at Screening and Baseline.
  4. Moderate-to-severe active TED (not sight-threatening but has an appreciable impact on daily life), usually associated with one or more of the following: lid retraction ≥ 2 mm, moderate or severe soft tissue involvement, exophthalmos ≥ 3 mm above normal for race and gender, and/or inconstant or constant diplopia.
  5. Onset of active TED symptoms (as determined by participant records) within 9 months prior to Baseline.
  6. Participants must be euthyroid with the baseline disease under control or have mild hypo- or hyperthyroidism (defined as free thyroxine [FT4] and free triiodothyronine [FT3] 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 clinical trial.
  7. Does not require immediate surgical ophthalmological intervention and is not planning corrective surgery/irradiation during the course of the study.
  8. (ALT) or AST ≤ 3 times the (ULN) or serum creatine \<1.5 times the ULN according to age at Screening.
  9. Diabetic participants must have well-controlled stable disease (defined as \< 9.0% with no new diabetic medication [oral or insulin] or more than a 10% change in the dose of a currently prescribed diabetic medication within 60 days prior to Screening).
  10. Women of (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 timepoints (i.e., prior to each dose and through Week 48 of the Follow-Up Period); participants who are sexually active with a non-vasectomized male partner must agree to use 2 reliable forms of during the trial, one of which is recommended to be hormonal, such as an oral contraceptive. Hormonal contraception must be started at least one full cycle prior to Baseline and continue for 180 days after the last dose of study drug. Highly effective contraceptive methods (with a failure rate less than 1% per year) when used consistently and correctly, includes implants, injectables, combined oral contraceptives, intrauterine devices (IUDs), sexual abstinence or vasectomized partner.
  11. Male participants must be surgically sterile or, if sexually active with a female partner of childbearing potential, must agree to use barrier contraceptive method from Screening through 180 days after the last dose of study drug.
  12. Participant is willing and able to comply with the study protocol and evaluations for the duration of the study.

Exclusion criteria

Exclusion Criteria:

  1. Decreased best corrected visual acuity due to optic neuropathy as 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.
  3. Decrease in CAS of ≥ 2 points in the study eye between Screening and Baseline.
  4. Decrease in proptosis of ≥ 2 mm in the study eye between Screening and Baseline.
  5. Previous orbital irradiation or surgery for TED.
  6. Any use (intravenous [IV] or oral) with a cumulative dose equivalent to ≥ 1 g of methylprednisolone for the treatment of TED. Previous steroid use (IV or oral) with a cumulative dose of \<1 g methylprednisolone or equivalent for the treatment of TED and previous use of steroid eye drops is allowed if the corticosteroid was discontinued at least 4 weeks prior to Screening.
  7. Corticosteroid use for conditions other than TED within 4 weeks prior to Screening (topical steroids for dermatological conditions and inhaled steroids are allowed).
  8. Selenium and biotin must be discontinued 3 weeks prior to Screening and must not be restarted during the clinical trial; however, taking a multivitamin that includes selenium and/or biotin is allowed.
  9. Any previous treatment with rituximab or tocilizumab. Use of any other non-steroid agent within 3 months prior to Screening.
  10. Use of an agent for any condition within 60 days prior to Screening or anticipated use during the course of the trial.
  11. Identified pre-existing ophthalmic disease that, in the judgment of the Investigator, would preclude study participation or complicate interpretation of study results.
  12. Bleeding diathesis that in the judgment of the Investigator would preclude inclusion in the clinical trial.
  13. Malignant condition in the past 12 months (except successfully treated basal/squamous cell carcinoma of the skin).
  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. -proven or clinically suspected inflammatory bowel disease.
  17. Known to any of the components of teprotumumab or prior hypersensitivity reactions to mAbs.
  18. Any other condition that, in the opinion of the Investigator, would preclude inclusion in the study.
  19. Previous enrollment in this study or participation in a prior teprotumumab clinical trial.
  20. (HIV), or infections.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
83 participants (actual)

Study arms

  • Active comparator
    Teprotumumab 20 mg/kg

    Approximately 38 participants will receive 8 infusions of teprotumumab q3W for a total of 21 weeks. Teprotumumab 10 mg/kg will be administered on Day 1 and teprotumumab 20 mg/kg will be administered q3W for the remaining 7 infusions.

    Biological: Teprotumumab

  • Placebo comparator
    Placebo

    Approximately 38 participants will receive 8 infusions of placebo q3W for a total of 21 weeks.

    Other: Placebo

Interventions

  • BiologicalTeprotumumab

    Teprotumumab is a fully human anti-IGF-1R mAb. Teprotumumab will be provided in single-dose 20 mL glass vials as a freeze-dried powder. Each vial of teprotumumab must be reconstituted with 10 mL of water for injection. Reconstituted teprotumumab solution must be further diluted in 0.9% (w/v) sodium chloride (NaCl) solution prior to administration. Teprotumumab 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).

    Also known as: HZN-001

  • OtherPlacebo

    Placebo will consist of normal saline (0.9% NaCl) solution and will be administered in 100 mL or 250 mL infusion bags, as would be appropriate, per weight-based dosing volumes (100 mL infusion bags for doses up to 1800 mg and 250 mL infusion bags for doses \> 1800 mg).

    Also known as: Saline solution

06

What researchers measure

Primary outcomes

  1. Percentage of Participants Who Were Proptosis Responders at Week 24

    Proptosis responders were defined as participants with a ≥2 mm reduction from Baseline in proptosis in the study eye, without deterioration (≥2 mm increase) of proptosis in the fellow eye at Week 24.

    Time frame: Week 24

Secondary outcomes

  1. Percentage of Participants Who Were Overall Responders at Week 24

    Overall responders were defined as participants with a ≥2 mm reduction in proptosis AND a ≥2 point reduction in Clinical Activity Score (CAS) from Baseline in the study eye, without deterioration (≥2 mm increase in proptosis or ≥2 point increase in CAS) in the fellow eye at Week 24. The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no clinical activity) to 7 (most clinical activity).

    Time frame: Week 24

  2. Percentage of Participants Who Were CAS Categorical Responders at Week 24 (Study Eye)

    CAS categorical responders were defined as participants with a reduction to a CAS of 0 or 1 (no or minimal inflammatory symptoms) in study eye. The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no inflammatory symptoms) to 7 (most inflammatory symptoms).

    Time frame: Week 24

  3. Change From Baseline in Proptosis to Week 24 (Study Eye)

    Time frame: Baseline, up to Week 24

  4. Percentage of Participants Who Were Diplopia Responders at Week 24

    Diplopia responders were defined as participants with Baseline diplopia Subjective Diplopia Score grade \>0 in the study eye who had a reduction of ≥1 grade with no corresponding deterioration (≥1 grade worsening) in the fellow eye at Week 24. Denominator is the number of subjects with diplopia at Baseline. The Subjective Diplopia Score is a clinical measure of diplopia severity on a grade scale of 0 to 3: 0=no diplopia; 1=intermittent (diplopia in primary position of gaze, when tired or when first awakening); 2=inconstant (diplopia at extremes of gaze); 3=constant (continuous diplopia in primary or reading position).

    Time frame: Week 24

  5. Change From Baseline in the Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire Overall Score to Week 24

    The GO-QoL is a 16-item self-administered questionnaire divided into 2 subsets and used to assess the perceived effects of TED by the subjects on (i) their daily physical activity as it relates to visual function, and (ii) psychosocial functioning. The range of the GO-QoL overall transformed scores is 0 to 100, where higher values correspond to better quality of life.

    Time frame: Baseline, up to Week 24

07

Results

Posted Mar 10, 2020

Participant flow

Double-Masked 24-Week Treatment Period
Participant flow — Double-Masked 24-Week Treatment Period
MilestonePlaceboTeprotumumab 20 mg/kg
Started4241
Completed4039
Not completed22
Withdrew: Adverse event11
Withdrew: Withdrawal by subject11
48-Week Follow-Up Period (Weeks 24-72)
Participant flow — 48-Week Follow-Up Period (Weeks 24-72)
MilestonePlaceboTeprotumumab 20 mg/kg
Started436
Completed320
Not completed116
Withdrew: Relapsed/entered optic-x19
Withdrew: Relapsed/did not enter optic-x01
Withdrew: Physician decision01
Withdrew: Withdrawal by subject02
Withdrew: Other, not specified01
Withdrew: Mis-classified as responders02
48-Week Follow-Up Contact (Weeks 96-120)
Participant flow — 48-Week Follow-Up Contact (Weeks 96-120)
MilestonePlaceboTeprotumumab 20 mg/kg
Started320
Completed319
Not completed01
Withdrew: Lost to follow-up01

Outcome measures

PrimaryPercentage of Participants Who Were Proptosis Responders at Week 24

Proptosis responders were defined as participants with a ≥2 mm reduction from Baseline in proptosis in the study eye, without deterioration (≥2 mm increase) of proptosis in the fellow eye at Week 24.

Time frame:
Week 24
Reported as:
Number · percentage of participants
Percentage of Participants Who Were Proptosis Responders at Week 24
percentage of participantsPlaceboTeprotumumab 20 mg/kg
Percentage of Participants Who Were Proptosis Responders at Week 249.582.9
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · Cochran-Mantel-Haenszel · p = <0.001 (Two-sided p-value calculated assuming the test statistic was distributed as a standard normal random variable.) · Stratified difference in percentages: 73.45 · 95% CI 58.89 to 88.01Stratified difference (teprotumumab - placebo) is a weighted average of the difference within each stratum. Estimates from the 2 strata (tobacco user, tobacco non-user) were combined with Cochran-Mantel-Haenszel (CMH) weights.
SecondaryPercentage of Participants Who Were Overall Responders at Week 24

Overall responders were defined as participants with a ≥2 mm reduction in proptosis AND a ≥2 point reduction in Clinical Activity Score (CAS) from Baseline in the study eye, without deterioration (≥2 mm increase in proptosis or ≥2 point increase in CAS) in the fellow eye at Week 24. The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no clinical activity) to 7 (most clinical activity).

Time frame:
Week 24
Reported as:
Number · percentage of participants
Percentage of Participants Who Were Overall Responders at Week 24
percentage of participantsPlaceboTeprotumumab 20 mg/kg
Percentage of Participants Who Were Overall Responders at Week 247.178.0
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · Cochran-Mantel-Haenszel · p = <0.001 (Two-sided p-value calculated assuming the test statistic was distributed as a standard normal random variable.) · Stratified difference in percentages: 70.82 · 95% CI 55.89 to 85.75Stratified difference (teprotumumab - placebo) is a weighted average of the difference within each stratum. Estimates from the 2 strata (tobacco user, tobacco non-user) were combined with CMH weights.
SecondaryPercentage of Participants Who Were CAS Categorical Responders at Week 24 (Study Eye)

CAS categorical responders were defined as participants with a reduction to a CAS of 0 or 1 (no or minimal inflammatory symptoms) in study eye. The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no inflammatory symptoms) to 7 (most inflammatory symptoms).

Time frame:
Week 24
Reported as:
Number · percentage of participants
Percentage of Participants Who Were CAS Categorical Responders at Week 24 (Study Eye)
percentage of participantsPlaceboTeprotumumab 20 mg/kg
Percentage of Participants Who Were CAS Categorical Responders at Week 24 (Study Eye)21.458.5
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · Cochran-Mantel-Haenszel · p = <0.001 (Two-sided p-value calculated assuming the test statistic was distributed as a standard normal random variable.) · Stratified difference in percentages: 36.03 · 95% CI 17.39 to 54.67Stratified difference (teprotumumab - placebo) is a weighted average of the difference within each stratum. Estimates from the 2 strata (tobacco user, tobacco non-user) were combined with CMH weights.
SecondaryChange From Baseline in Proptosis to Week 24 (Study Eye)
Time frame:
Baseline, up to Week 24
Reported as:
Least squares mean · mm
Change From Baseline in Proptosis to Week 24 (Study Eye)
mmPlaceboTeprotumumab 20 mg/kg
Change From Baseline in Proptosis to Week 24 (Study Eye)-0.54 ± 0.192-2.82 ± 0.191
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · mixed model for repeated measures (MMRM) · p = <0.001 (Results obtained from an MMRM with an unstructured covariance matrix including the following terms: Baseline value, tobacco use status, treatment group, visit, visit-by-treatment interaction and visit-by-Baseline-value interaction.) · Ls mean difference: -2.28 · 95% CI -2.77 to -1.80
SecondaryPercentage of Participants Who Were Diplopia Responders at Week 24

Diplopia responders were defined as participants with Baseline diplopia Subjective Diplopia Score grade \>0 in the study eye who had a reduction of ≥1 grade with no corresponding deterioration (≥1 grade worsening) in the fellow eye at Week 24. Denominator is the number of subjects with diplopia at Baseline. The Subjective Diplopia Score is a clinical measure of diplopia severity on a grade scale of 0 to 3: 0=no diplopia; 1=intermittent (diplopia in primary position of gaze, when tired or when first awakening); 2=inconstant (diplopia at extremes of gaze); 3=constant (continuous diplopia in primary or reading position).

Time frame:
Week 24
Reported as:
Number · percentage of participants
Percentage of Participants Who Were Diplopia Responders at Week 24
percentage of participantsPlaceboTeprotumumab 20 mg/kg
Percentage of Participants Who Were Diplopia Responders at Week 2428.667.9
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · Cochran-Mantel-Haenszel · p = 0.001 (Two-sided p-value calculated assuming the test statistic was distributed as a standard normal random variable.) · Stratified difference in percentages: 39.29 · 95% CI 15.55 to 63.02Stratified difference is a weighted average of the difference within each stratum. Estimates from the 2 strata (tobacco user, tobacco non-user) were combined with CMH weights.
SecondaryChange From Baseline in the Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire Overall Score to Week 24

The GO-QoL is a 16-item self-administered questionnaire divided into 2 subsets and used to assess the perceived effects of TED by the subjects on (i) their daily physical activity as it relates to visual function, and (ii) psychosocial functioning. The range of the GO-QoL overall transformed scores is 0 to 100, where higher values correspond to better quality of life.

Time frame:
Baseline, up to Week 24
Reported as:
Least squares mean · score on a scale
Change From Baseline in the Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire Overall Score to Week 24
score on a scalePlaceboTeprotumumab 20 mg/kg
Change From Baseline in the Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire Overall Score to Week 244.43 ± 2.10213.79 ± 2.074
Statistical analysis
  • Placebo vs Teprotumumab 20 mg/kg · mixed model for repeated measures (MMRM) · p = <0.001 (Results obtained from an MMRM with an unstructured covariance matrix including the following terms: Baseline value, tobacco use status, treatment group, visit, visit-by-treatment interaction and visit-by-Baseline-value interaction.) · Difference in ls mean: 9.36 · 95% CI 4.08 to 14.64

Adverse events

Collected over From first dose of study drug through the end of the Double-Masked Treatment Period (up to 24 weeks) plus 3 weeks.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Placebo0/42 (0%)1/42 (2.4%)29/42 (69%)
Teprotumumab 20 mg/kg0/41 (0%)2/41 (4.9%)37/41 (90.2%)
Most frequent serious events
Most frequent serious events
EventPlaceboTeprotumumab 20 mg/kg
Infusion related reactionInjury, poisoning and procedural complications0/421/41
PneumothoraxRespiratory, thoracic and mediastinal disorders0/421/41
Visual field defectNervous system disorders1/420/41
Most frequent other events
Showing 10 of 15
Most frequent other events
EventPlaceboTeprotumumab 20 mg/kg
Muscle SpasmsMusculoskeletal and connective tissue disorders4/4214/41
AlopeciaSkin and subcutaneous tissue disorders5/4210/41
NauseaGastrointestinal disorders4/426/41
DiarrhoeaGastrointestinal disorders5/425/41
FatigueGeneral disorders1/425/41
Dry SkinSkin and subcutaneous tissue disorders0/425/41
DysgeusiaNervous system disorders0/424/41
HeadacheNervous system disorders4/424/41
AmenorrhoeaReproductive system and breast disorders0/424/41
StomatitisGastrointestinal disorders1/423/41

Baseline characteristics

Age, Continuous
Age, Continuous(years)PlaceboTeprotumumab 20 mg/kgTotal
Mean48.9 ± 12.9651.6 ± 12.6350.2 ± 12.79
Age, Customized
Age, Customized(Participants)PlaceboTeprotumumab 20 mg/kgTotal
<65 years383270
≥65 years4913
Sex: Female, Male
Sex: Female, Male(Participants)PlaceboTeprotumumab 20 mg/kgTotal
Female312960
Male111223
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PlaceboTeprotumumab 20 mg/kgTotal
Hispanic or Latino123
Not Hispanic or Latino413980
Unknown or Not Reported000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)PlaceboTeprotumumab 20 mg/kgTotal
Asian123
Black or African American246
White373572
More Than 1 Race202
Tobacco use status - as randomized
Tobacco use status - as randomized(Participants)PlaceboTeprotumumab 20 mg/kgTotal
Non-User333265
User9918
Tobacco use status - actual
Tobacco use status - actual(Participants)PlaceboTeprotumumab 20 mg/kgTotal
Non-User343266
User8917
08

Study locations

14 sites
  • Macro, Llc
    Beverly Hills, California 90212, United States
  • Cedars-Sinai Medical Center
    Los Angeles, California 90078, United States
  • The Lennar Foundation Medical
    Coral Gables, Florida 33146, United States
  • Bascom Palmer Eye Institute
    Miami, Florida 33136, United States
  • Kellogg Eye Center at University of Michigan
    Ann Arbor, Michigan 48105, United States
  • Casey Eye Institute at Oregon Health and Science University
    Portland, Oregon 97239, United States
  • Hamilton Eye Institute at University of Tennessee Health Science Center
    Memphis, Tennessee 38163, United States
  • Eye Wellness Center
    Houston, Texas 77005, United States
  • Medical College of Wisconsin, The Eye Institute
    Milwaukee, Wisconsin 53226, United States
  • University Hospital Essen, Department of Ophthalmology
    Essen, 45147, Germany
  • Johannes Gutenberg University Medical Center
    Mainz, 55131, Germany
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
    Milan, 20122, Italy
  • University of Pisa, Department of Clinical and Experimental Medicine
    Pisa, 56100, Italy
  • University of Pisa,Department of Clinical and Experimental Medicine, Endocrinology Unit
    Pisa, 56124, Italy
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References and documents

Publications

  • Douglas RS, Kahaly GJ, Patel A, Sile S, Thompson EHZ, Perdok R, Fleming JC, Fowler BT, Marcocci C, Marino M, Antonelli A, Dailey R, Harris GJ, Eckstein A, Schiffman J, Tang R, Nelson C, Salvi M, Wester S, Sherman JW, Vescio T, Holt RJ, Smith TJ. Teprotumumab for the Treatment of Active Thyroid Eye Disease. N Engl J Med. 2020 Jan 23;382(4):341-352. doi: 10.1056/NEJMoa1910434. PubMed 31971679 ↗
  • Jain AP, Gellada N, Ugradar S, Kumar A, Kahaly G, Douglas R. Teprotumumab reduces extraocular muscle and orbital fat volume in thyroid eye disease. Br J Ophthalmol. 2022 Feb;106(2):165-171. doi: 10.1136/bjophthalmol-2020-317806. Epub 2020 Nov 10. PubMed 33172865 ↗

Related links

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report

Time frame: Data sharing requests relating to this study will be considered beginning 18 months after the study has ended and either 1) the product and indication have been granted marketing authorization in both the US and Europe or 2) clinical development for the product and/or indication discontinues and the data will not be submitted to regulatory authorities. There is no end date for eligibility to submit a data sharing request for this study.

Access criteria: Qualified researchers may submit a request containing the research objectives, the Amgen product(s) and Amgen study/studies in scope, endpoints/outcomes of interest, statistical analysis plan, data requirements, publication plan, and qualifications of the researcher(s). In general, Amgen does not grant external requests for individual patient data for the purpose of re-evaluating safety and efficacy issues already addressed in the product labelling. Requests are reviewed by a committee of internal advisors. If not approved, a Data Sharing Independent Review Panel will arbitrate and make the final decision. Upon approval, information necessary to address the research question will be provided under the terms of a data sharing agreement. This may include anonymized individual patient data and/or available supporting documents, containing fragments of analysis code where provided in analysis specifications. Further details are available at the URL below.

Data sharing details ↗ · www.amgen.com

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 11, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03298867
Lead sponsor
Amgen
Responsible party
Sponsor
First posted
Oct 2, 2017
Start date
Oct 4, 2017
Primary completion
Feb 13, 2019
Completion
Nov 30, 2020
Results posted
Mar 10, 2020
Last update
Jul 11, 2024

Study contacts

MD
study director · Amgen

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Teprotumumab

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