New survey assessment finds debilitating impact of thyroid eye disease (TED) on quality of life continues well beyond acute disease into chronic phase.- Horizon Therapeutics

Horizon Therapeutics plc announced results of a new Thyroid Eye Disease (TED) quality of life (QOL) assessment presented at the North American Neuro-Ophthalmology Society (NANOS) 2021 Virtual Annual Meeting.Findings demonstrate that TED not only has a significant burden on patients during the acute (active) phase of the disease, but that this burden continues well into the chronic (inactive) phase. TED is a rare autoimmune disease that begins with an acute phase where inflammatory signs and symptoms, such as eye pain, swelling, proptosis(eye bulging) and diplopia (double vision), progress over time. The disease then changes to a chronic phase where inflammation may slow or stop, but signs and symptoms often remain. The online survey assessed 100 patients with chronic TED at various levels of severity . Patient characteristics and TED parameters were measured both at the time of diagnosis and after being told their TED was in the chronic phase. QOL was measured using the Graves’ Ophthalmopathy Quality of Life Questionnaire (GO-QOL) instrument. Scores range from 0 (worst) to 100 (best), with a score of 90-100 considered normal. Scores were stratified as low (less than 50), middle (50-75) and high (greater than 75). Key findings include the following : i GO-QOL scores averaged approximately 60 points across examined categories (overall score, appearance sub-score and visual function sub-score). ii. Patients with the worst QOL reported the highest number of TED signs and symptoms, specifically with orbital pain, blurry vision, light sensitivity and diplopia having the most influence on QOL. iii. Several symptoms present during the acute .phase commonly persisted into the chronic phase, including ocular dryness/grittiness, light sensitivity, blurry vision and pain behind the eyes. iv.Nearly half (42%) of respondents reported anxiety or depression v. Anxiety also increased as QOL declined (17% in the high QOL group vs. 48% in the low QOL group).vi. Importantly, interventions such as surgery and use of oral or IV glucocorticoids did not lead to a higher QOL during chronic TED. “The results of this (Quality of LIfe ) survey challenge our traditional understanding of the phases of Thyroid Eye Disease and its impact on patients,” said Kimberly Cockerham, M.D., adjunct clinical associate professor, Department of Ophthalmology, Stanford University School of Medicine and primary author of the study. “A common belief is that once a patient progresses to the chronic phase of the disease, symptoms diminish and the impact on quality of life improves. But in this survey, the quality of life of patients with chronic Thyroid Eye Disease was reported to be significantly impaired and nearly identical to scores seen in clinical trials of patients with acute, moderate-to-severe disease.”