"This is the first approval for TEPEZZA in Asia and marks a significant milestone for the global treatment of TED," said Jay Bradner, M.D., executive vice president, Research and Development, and chief scientific officer at Amgen. "Historically, patients with TED have been managed with complex surgeries and high-dose steroids, which can cause further complications. With TEPEZZA, doctors have a nonsurgical and nonsteroidal option that treats a root cause of this debilitating disease."
TEPEZZA received orphan drug designation in Japan , which provided a nine-month regulatory review period compared to the standard 12-month review. The approval was based on the positive results of OPTIC-J ( jRCT2031210453 ), a Phase 3 randomized, double-masked, placebo-controlled, parallel-group, multicenter study evaluating the efficacy, tolerability and safety of TEPEZZA in the treatment of patients with active TED in Japan .
The primary endpoint in the trial was met, as 89% of patients treated with TEPEZZA had a clinically meaningful improvement in proptosis (≥2 mm) compared with placebo (11%; p 3 A second Phase 3 clinical trial is ongoing in Japan evaluating TEPEZZA among adults with chronic TED and a low CAS ( jRCT2031220730 ).
"People living with active TED can experience a significant burden of disease with symptoms that can make daily life difficult to navigate," said Yuji Hiromatsu , M.D., a professor emeritus at the Kurume University Medical Center and physician at the Diabetes, Thyroid and Endocrine Center at the Shin-Koga Hospital. "The approval of TEPEZZA in Japan is an important advancement for patients and offers a new treatment option that targets the underlying mechanism of the disease."
In addition to Japan , TEPEZZA is currently approved in the United States, Brazil and the Kingdom of Saudi Arabia, and is under regulatory review in Europe , Canada and Australia .
About Thyroid Eye Disease (TED)
TED is a serious, progressive, debilitating and potentially vision-threatening rare autoimmune disease. 4 It often occurs in people living with Graves' disease, but is a distinct disease that is caused by autoantibodies activating an insulin-like growth factor-1 receptor (IGF-1R)-mediated signaling complex on cells within the retro-orbital space. 5 , 6 This leads to a cascade of negative effects, which may cause long-term, irreversible damage, including blindness. 7 , 8 Signs and symptoms of TED may include dry eyes and grittiness; redness, swelling and excessive tearing; eyelid retraction; proptosis; pressure and/or pain behind the eyes; and diplopia.
Important Japan Product information
PRODUCT NAME | TEPEZZA ® for Intravenous Infusion 500 mg |
Generic Name (JAN) | Teprotumumab (Genetical Recombination) |
Indication | Active thyroid eye disease |
Precautions related to
indications | Hearing disorders (e.g., deafness, hypoacusis, Eustachian tube dysfunction, patulous Eustachian tube, hyperacusis, tinnitus, and tympanic membrane disorder) may occur during treatment with TEPEZZA, and serious and irreversible events have also been reported. Patients eligible for TEPEZZA therapy should be selected based on a thorough understanding of the information provided in "17. Clinical Results," the backgrounds of the patients in the clinical studies, and the results of the studies of the efficacy and safety of TEPEZZA. Clinical studies of the efficacy and safety in patients with mild active thyroid eye disease have not been conducted. |
Dose and Administration | The usual adult dosage is 10 mg/kg as teprotumumab (genetical recombination) for the first dose and 20 mg/kg for the second and subsequent doses, administered intravenously every 3 weeks, for a total of 8 infusions. |
About TEPEZZA ® (teprotumumab-trbw) in the U.S.
U.S. INDICATION
TEPEZZA ® is indicated for the treatment of Thyroid Eye Disease regardless of Thyroid Eye Disease activity or duration.
U.S. IMPORTANT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Infusion Reactions: TEPEZZA may cause infusion reactions. Infusion reactions have been reported in approximately 4% of patients treated with TEPEZZA. Reported infusion reactions have usually been mild or moderate in severity. Signs and symptoms may include transient increases in blood pressure, feeling hot, tachycardia, dyspnea, headache, and muscular pain. Infusion reactions may occur during an infusion or within 1.5 hours after an infusion. In patients who experience an infusion reaction, consideration should be given to premedicating with an antihistamine, antipyretic, or corticosteroid and/or administering all subsequent infusions at a slower infusion rate.
Preexisting Inflammatory Bowel Disease: TEPEZZA may cause an exacerbation of preexisting inflammatory bowel disease (IBD). Monitor patients with IBD for flare of disease. If IBD exacerbation is suspected, consider discontinuation of TEPEZZA.
Hyperglycemia: Increased blood glucose or hyperglycemia may occur in patients treated with TEPEZZA. In clinical trials, 10% of patients (two-thirds of whom had preexisting diabetes or impaired glucose tolerance) experienced hyperglycemia. Hyperglycemic events should be controlled with medications for glycemic control, if necessary. Assess patients for elevated blood glucose and symptoms of hyperglycemia prior to infusion and continue to monitor while on treatment with TEPEZZA. Ensure patients with hyperglycemia or preexisting diabetes are under appropriate glycemic control before and while receiving TEPEZZA.
Hearing Impairment Including Hearing Loss: TEPEZZA may cause severe hearing impairment including hearing loss, which in some cases may be permanent. Assess patients' hearing before, during, and after treatment with TEPEZZA and consider the benefit-risk of treatment with patients.
ADVERSE REACTIONS
The most common adverse reactions (incidence ≥5% and greater than placebo) are muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, dry skin, weight decreased, nail disorders, and menstrual disorders.
Please click here for Full TEPEZZA U.S. Prescribing Information.
About Amgen
Amgen discovers, develops, manufactures and delivers innovative medicines to help millions of patients in their fight against some of the world's toughest diseases. More than 40 years ago, Amgen helped to establish the biotechnology industry and remains on the cutting-edge of innovation, using technology and human genetic data to push beyond what's known today. Amgen is advancing a broad and deep pipeline that builds on its existing portfolio of medicines to treat cancer, heart disease, osteoporosis, inflammatory diseases and rare diseases.
In 2024, Amgen was named one of the "World's Most Innovative Companies" by Fast Company and one of "America's Best Large Employers" by Forbes, among other external recognitions . Amgen is one of the 30 companies that comprise the Dow Jones Industrial Average ® , and it is also part of the Nasdaq-100 Index ® , which includes the largest and most innovative non-financial companies listed on the Nasdaq Stock Market based on market capitalization.
For more information, visit Amgen.com and follow Amgen on X , LinkedIn , Instagram , TikTok , YouTube and Threads .
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References
- Smith TJ, Kahaly GJ, Ezra DG, et al. Teprotumumab for thyroid-associated ophthalmopathy. N Engl J Med. 2017;376(18):1748-1761.
- Natsuko W et al. J Endocr Soc. 2023 Nov 27;8(1):bvad148.
- Yuji Hiromatsu , et al. "Efficacy and Safety of Teprotumumab in Japanese Patients with Active Thyroid Eye Disease." The 66th Annual Meeting of the Japan Thyroid Association, December 9, 2023 . Abstract No.O13-5.
- Barrio-Barrio J, et al. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. Journal of Ophthalmopathy . 2015;2015:249125.
- Weightman DR, et al. Autoantibodies to IGF-1 Binding Sites in Thyroid Associated Ophthalmopathy. Autoimmunity . 1993;16(4):251–257.
- Pritchard J, et al. Immunoglobulin Activation of T Cell Chemoattractant Expression in Fibroblasts from Patients with Graves' Disease Is Mediated Through the Insulin-Like Growth Factor 1 Receptor Pathway. J Immunol . 2003;170:6348-6354.
- McKeag D, et al. Clinical features of dysthyroid optic neuropathy: a European Group on Graves' Orbitopathy (EUGOGO) survey. Br J Ophthalmol . 2007;91:455-458.
- Bartalena L, Kahaly GJ, Baldeschi L, et al. The 2021 European Group on Graves' Orbitopathy (EUGOGO) Clinical Practice Guidelines for the Medical Management of Graves' Orbitopathy. Eur J Endocrinol . 2021.
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