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New topline Tepezza data confirms its efficacy in longer disease duration, long-term durability and potential for retreatment in people living with thyroid eye disease (TED). Horizon Therapeutics
Horizon Therapeutics plc announced positive topline data from two clinical trials that add to the growing body of evidence supporting the efficacy and safety of Tepezza (teprotumumab-trbw) for the treatment of Thyroid Eye Disease (TED) . Tepezza is the first and only medicine approved by the FDA for the treatment of TED – a serious, progressive and vision-threatening rare autoimmune disease.
The OPTIC Phase III confirmatory clinical trial and the OPTIC-X open-label extension clinical trial are part of Horizon’s development program to evaluate the safety and efficacy of Tepezza in people living with TED. The OPTIC Phase III confirmatory clinical trial included a 24-week treatment period and a 48-week off-treatment follow-up period. The OPTIC 24-week treatment period evaluated patients who received Tepezza or placebo once every three weeks for a total of eight infusions. The primary endpoint was a 2 mm or more reduction of proptosis (eye bulging) from baseline in the study eye (without deterioration in the fellow eye) at Week 24. At Week 24 of OPTIC, proptosis responders entered into a 48-week off-treatment follow-up period, without receiving additional TED treatment, including Tepezza.
OPTIC-X evaluated the safety and efficacy of Tepezza in TED patients who were enrolled in OPTIC and were either proptosis non-responders at Week 24 of OPTIC, or were proptosis responders at Week 24 but relapsed during the 48-week off-treatment follow-up period . Non-responders were defined as patients who did not achieve at least a 2 mm proptosis improvement from baseline at Week 24 of OPTIC. Relapse was defined as patients who lost at least 2 mm of their Week 24 proptosis improvement during the 48-week off-treatment follow-up period – even if their proptosis was still substantially better than at baseline of OPTIC – or who had a substantial increase in the number of inflammatory signs or symptoms without worsening proptosis. Patients could qualify as relapsing at any point during the 48-week off-treatment follow-up period of OPTIC.
Topline data include the following :1. 89 percent of patients (33/37) who received placebo during the OPTIC trial and then entered OPTIC-X and received Tepezza achieved the primary endpoint of a 2 mm or more reduction in proptosis at Week 24 (average reduction of -3.5 mm). This is consistent with results from the OPTIC trial, where 83 percent of Tepezza patients (n=41) had a proptosis reduction of 2 mm or more at Week 24 (average reduction of -3.3 mm). 2.The results for other OPTIC-X endpoints, including diplopia and Clinical Activity Score (CAS), are similar to what was observed in OPTIC. 3. These patients who received placebo in OPTIC and their first course of Tepezza in OPTIC-X had a TED diagnosis for an average of one year and as long as 16 months, compared with an average of six months in the OPTIC trial. 4.In the OPTIC 48-week off-treatment follow-up period, the majority of Tepezza patients who were proptosis responders at Week 24 in OPTIC maintained their proptosis response at Week 72 (19/34; 56 percent) without receiving additional TED treatment. Of the 15 patients who did not qualify as maintaining a proptosis response, eight patients were at least 2 mm better than baseline at the time of their last assessment in the OPTIC 48-week off-treatment follow-up period. The 15 patients include four who prematurely discontinued the study, two who had worsened slightly but not enough to qualify as relapsed for OPTIC-X and nine who met the OPTIC-X criteria for relapse prior to Week 72 of the off-treatment follow-up period (eight of whom entered OPTIC-X for retreatment and one who did not enroll in OPTIC-X). 5. Similar durability from Week 24 to Week 72 was demonstrated for other endpoints in the OPTIC 48-week off-treatment follow-up period, including diplopia and CAS.For relapsed patients who were retreated. 6. with an additional course of Tepezza, more than 60 percent had a 2 mm or more proptosis improvement from OPTIC-X baseline at Week 24. 7.Only five patients had not achieved a proptosis response after completing a full course of Tepezza in OPTIC. Of these, two achieved a 2 mm or more proptosis reduction in OPTIC-X after an additional course of tepezza. 8.There were no new safety concerns in OPTIC-X or the OPTIC 48-week off-treatment follow-up period, including in patients who received additional Tepezza treatment.
About the OPTIC 48-Week Follow-Up Period : OPTIC (Treatment of Graves’ Orbitopathy [Thyroid Eye Disease] to Reduce Proptosis with Teprotumumab Infusions in a Randomized, Placebo-Controlled, Clinical Study) was a multicenter, randomized, double-blind, placebo-controlled trial. This Phase 3 confirmatory clinical trial included a 24-week treatment period and a 48-week off-treatment follow-up period. At the end of the 24-week treatment period, patients who were proptosis responders entered into the 48-week off-treatment follow-up period, without receiving additional TED treatment, including Tepezza. Clinic visits were scheduled for Weeks 28, 36, 48, 60, and 72 (Months 7, 9, 12, 15, and 18). Sustained proptosis response in the OPTIC 48-week off-treatment follow-up period was defined as a 2 mm or more proptosis improvement from OPTIC baseline at Week 24, a 2 mm or more proptosis improvement from OPTIC baseline at Week 72 and no additional TED treatment, including Tepezza.
Condition: Thyroid Eye Disease
Type: drug