34839 Game-changer or flop: Teprotumumab may not provide lasting improvement of pretibial myxedema

Abstract

Introduction: Pretibial myxedema (PTM) is characterized by asymmetric, non-pitting edema, firm nodules, and indurated plaques mostly on the legs, ankles, and feet. Persistent lymphedema and elephantiasis can be debilitating. PTM is associated with autoimmune thyroid disorders. Treatment is limited; corticosteroids are gold standard. Alternative therapies like octreotide, an insulin-like growth factor-I receptor (IGF-IR) antagonist, are often used without improvement. Thyroid-associated ophthalmopathy (TAO), swelling of the retro-ocular tissue, is almost always coexistent with PTM.