Hearing Loss in Hyperthyroid Patients Treated with Tepezza

Monday, October 13, 2025

8:00 AM - 8:06 AM EDT

Location: 244

Disclosure(s):

Murilo W. de Santana Hager, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nicole M. Favre, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Paula Valeria Guerra-Navarro, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan A. Dewan:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hyperthyroidism impacts about 1.2% of the U.S. population, leading to complications that can affect the heart and eyes. Tepezza (teprotumumab-trbwa), a monoclonal antibody that targets insulin-like growth factor 1 receptor, has been used to treat Graves’ ophthalmopathy (GED). While Tepezza is beneficial for GED, previous case reports and pharmacovigilance data suggest potential otologic side effects from this treatment. Our study aims to quantify the risk of hearing loss associated with Tepezza use in hyperthyroid patients.

Methods: A retrospective cohort study using the TriNetX Collaborative Network was used to identify patients with hyperthyroidism (ICD-10 code E05) from 2006 to 2024. Two groups were established: one comprised of patients treated with Tepezza and a control group of patients not treated with Tepezza. Hearing loss was categorized as sensorineural (ICD-10 H90.A2, H90.A3, H90.A4, H90.A5), mixed (ICD-10 H90.A3, H90.A6, H90.A7, H90.A8), conductive (ICD-10 H90.0, H90.A1, H90.1, H90.2), or unspecified (ICD-10 H91.9). Cases of hearing loss occurring after Tepezza initiation (in the treated group) or after hyperthyroidism diagnosis (in the control group) were recorded. Relative risk was calculated within a 95% confidence interval. Groups were propensity score matched for age and gender.

Results: After matching, each cohort yielded 1082 (793 (73.3%) F, 258 (23.8%) M, 31(2.9%) Unknown) patients with a mean age of 55.9 (SD=14.6) years. The Tepezza group was 3.15 times more likely to be diagnosed with sensorineural hearing loss, with 154 (14.2%) diagnosed compared to 51 (4.7%) in the untreated group (CI: 2.31-4.2; p<.001). The Tepezza group was also 1.66 times more likely to develop unspecified hearing loss, with 78 (7.2%) diagnosed compared to 47 (4.3%) (CI:1.17-2.36; p=.006).

Conclusions: Tepezza use in hyperthyroid patients is associated with a higher risk of sensorineural and unspecified hearing loss. These findings underscore the importance of vigilant monitoring when prescribing this medication for GED.

Presenting Author(s)

Murilo W. de Santana Hager, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

CC

Chloe J. Cottone, BA

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Bufalo, NY, United States

Disclosure information not submitted.
Nicole M. Favre, MD

Resident Physician
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
PG

Paula Valeria Guerra-Navarro, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Ryan A. Dewan

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
ME

Mohamed Elrakhawy, MD

Assistant Professor
Department of Otorhinolaryngology, Rush University Medical Center
IL, IL, United States

Disclosure information not submitted.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure information not submitted.