Los Angeles – October 12, 2026 -- TED patients with pre-existing hearing loss were more than 60% less likely to suffer a further hearing decline when teprotumumab (TEPEZZA) infusions were spaced six weeks apart instead of the standard three, according to a retrospective study presented at the ASOPRS 57th Annual Fall Scientific Symposium.
Hearing decline hit 45% of patients on the standard schedule at 24 weeks
Nine of 20 patients (45%) on the standard three-week schedule showed a clinically significant decline on formal audiometry at 24 weeks. On the six-week schedule, the rate was about one in six. Clinical significance was defined using American Speech-Language-Hearing Association (ASHA) criteria.
The symposium ran October 8-9, 2026, at the Hyatt Regency New Orleans. Shoaib Ugradar, MD, was the presenting author. The study was led by Raymond Douglas, MD, PhD.
Study covered 38 patients who all had hearing loss before their first infusion
The team reviewed 38 consecutive TED patients treated with teprotumumab. Formal audiometry confirmed hearing loss in every patient before treatment. Patients were offered the option of the six-week schedule, which produced two groups similar in age and sex:
- Six-week schedule: 18 patients (13 women, 5 men; average age 57)
- Standard three-week schedule: 20 patients (16 women, 4 men; average age 57)
Audiometry was performed before treatment and again at 24 weeks.
Efficacy held steady across inflammation, eye bulging and double vision
The two groups showed no significant differences in improvement in inflammation, eye bulging, or double vision. The longer interval did not appear to reduce treatment effectiveness.
Hearing side effects reach up to 50% in high-risk patients
Teprotumumab is the first FDA-approved medicine for thyroid eye disease. The approved regimen is eight infusions given three weeks apart. Hearing-related side effects were reported in about 10% of patients in the phase 2 and phase 3 trials, and in as many as 50% of high-risk patients with hearing problems before treatment. No established protocol existed specifically for TED patients with existing hearing loss.
Douglas said patients with existing hearing loss have named this side effect as their greatest concern, and he urged close hearing monitoring before and throughout treatment.
Retrospective design and small sample limit the findings
The researchers said larger prospective studies are needed to confirm the results. The research was not presented as an endorsement of any change to the FDA-approved dosing schedule, and patients should not alter their treatment schedule on their own.
Douglas and Terry J. Smith receive 2026 ASOPRS award
Douglas and longtime collaborator Terry J. Smith, MD, received the 2026 ASOPRS Outstanding Contribution Award for their research on thyroid eye disease. Douglas began that work during his fellowship at UCLA, launching more than two decades of research on the IGF-1R pathway that contributed to the development of teprotumumab.