Post by Mikhail Khachaturov

Veligrotug-vvze / Lumvoa has been approved by the FDA for the treatment of thyroid eye disease. This is an IGF-1R antagonist, targeting one of the key pathways involved in orbital fibroblast activation, tissue remodeling, proptosis and diplopia in TED. Why is this important? First, Lumvoa is administered as 5 intravenous infusions over 12 weeks, which is a shorter treatment course than the 8-infusion regimen used with teprotumumab. Second, the approval is supported by phase 3 data in both: 🔴 active TED - THRIVE 🔴 chronic TED - THRIVE-2 This is particularly interesting because chronic TED has historically been a more difficult area for medical therapy. In THRIVE, veligrotug showed a rapid and clinically meaningful effect on proptosis and diplopia in active TED. In THRIVE-2, the signal extended to chronic TED, with improvement in proptosis and diplopia even in patients with long-standing disease. This does not mean that veligrotug is “better” than teprotumumab. There is no head-to-head trial. But it does mean that the TED treatment landscape is becoming more targeted, more competitive and more nuanced. Key clinical questions remain: - durability of response - hearing-related safety - hyperglycaemia - infusion reactions - inflammatory bowel disease risk - patient selection - access and cost We are moving toward a more personalized treatment model based on disease activity, duration, severity, proptosis, diplopia, safety profile and patient priorities. As someone working with TED, I really hope these targeted therapies will eventually become accessible to more patients globally. Illustration from the published THRIVE phase 3 trial in Ophthalmology: https://lnkd.in/eeHwD3Ch #ThyroidEyeDisease #GravesDisease #Endocrinology #Ophthalmology #TED #IGF1R #Veligrotug #Lumvoa #OrbitalDisease