Objective:

To describe serum IGF-1 dynamics in patients with thyroid eye disease (TED) treated with teprotumumab N01 and explore their relationship with glycemic changes.

Approach:

• Study Design: Retrospective cohort study of 92 patients with moderate-to-severe TED treated with teprotumumab N01, assessing IGF-1 and glycemic markers.
• Data Collection: Clinical and laboratory data were extracted from medical records, focusing on IGF-1 measurements and glycemic changes.
• Statistical Analysis: Multivariable linear regression and logistic regression were used to evaluate associations between IGF-1 metrics and glycemic changes.

Key Findings:

• Baseline serum IGF-1 was 151.0 ng/mL.
• IGF-1 increased markedly after treatment initiation, with a median peak concentration of 649.5 ng/mL.
• Glycemic markers showed modest increases, with median peak increases in HbA1c, GA, and FBG.
• Glycemic deterioration was most pronounced in patients with baseline dysglycemia.
• IGF-1 dynamics were not independent correlates of glycemic changes after adjustments.

Interpretation:

Teprotumumab N01 treatment led to significant increases in circulating IGF-1, but these changes did not correlate independently with glycemic deterioration.

Limitations:

• Retrospective design may introduce bias.
• Limited generalizability due to single-center study.
• Potential confounding factors not fully accounted for.

Conclusion:

Teprotumumab N01 treatment is associated with substantial increases in circulating IGF-1, which are broadly reversible, but do not serve as independent indicators of glycemic deterioration.