Raymond Douglas Presents Six-Week Teprotumumab Schedule at ASOPRS Symposium
Spacing teprotumumab infusions six weeks apart rather than the standard three weeks may protect hearing in thyroid eye disease patients who already suffer from hearing loss, according to research presented by Dr. Raymond Douglas, MD, PhD. Newswise reported that the findings were unveiled on October 8–9, 2026, at the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) 57th Annual Fall Scientific Symposium at the Hyatt Regency New Orleans. Teprotumumab, marketed as TEPEZZA, is the first FDA-approved medication for thyroid eye disease, an autoimmune condition characterized by eye bulging, inflammation, and double vision. While the standard regimen consists of eight infusions given at three-week intervals, clinical trials indicate that hearing-related side effects occur in roughly 10% of typical patients and up to 50% of high-risk individuals with preexisting hearing problems.
Audiometric Decline and Clinical Efficacy in 38 Evaluated Patients
Dr. Douglas and his research team analyzed 38 consecutive thyroid eye disease patients with audiometry-confirmed hearing loss prior to their first infusion. Among them, 18 patients opted for the six-week schedule, comprising 13 women and 5 men with an average age of 57, while 20 patients followed the standard three-week schedule, comprising 16 women and 4 men with an average age of 57. Formal audiometry testing at 24 weeks revealed that nearly half of the standard schedule group—45%, or 9 out of 20 patients—experienced a clinically significant hearing decline. In contrast, only about one in six patients on the six-week schedule suffered a similar decline, making those patients more than 60% less likely to experience hearing deterioration. Furthermore, the extended dosing interval did not compromise treatment efficacy, as both groups showed comparable improvements in inflammation, eye bulging, and double vision.
ASOPRS Outstanding Contribution Award and Research History
Alongside the presentation of the six-week dosing study, Dr. Douglas and his longtime collaborator Dr. Terry J. Smith received the 2026 ASOPRS Outstanding Contribution Award. The distinction recognizes members whose project-based work yields a significant impact on the field beyond standard committee service. Dr. Douglas initiated his research into thyroid eye disease during his fellowship at UCLA under Dr. Robert Goldberg and Dr. Terry Smith, establishing more than two decades of investigation into the IGF-1R pathway that ultimately enabled the development of teprotumumab. As a lead scientist and principal investigator of the international clinical trials that secured FDA approval, Dr. Douglas administered the therapy to the world’s first post-approval patients.
Frequently Asked Questions About the Teprotumumab Study
How was hearing measured during the study?
Patient hearing was evaluated using formal audiometry, recognized as the gold standard for measuring hearing function, before treatment and again at the 24-week mark. Clinically significant changes were classified according to American Speech-Language-Hearing Association criteria.
Do the study authors recommend patients change their dosing schedule independently?
No, the research was not presented as an endorsement of any alteration to the FDA-approved dosing schedule. Patients currently receiving or considering teprotumumab are advised to consult their physicians regarding hearing monitoring and appropriate dosing approaches.
What are the limitations of this specific clinical evaluation?
Researchers noted that the investigation was a retrospective study involving a relatively small patient cohort of 38 individuals. Consequently, larger prospective studies are required to confirm the findings before any formal protocol changes are established.
Worth a look