Hearing loss in hyperthyroid patients treated with teprotumumab (TepezzaR)
- Journal
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Q1)
- Published
- 10 August 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Murilo de Santana Hager, Chloe Cottone, Paula Valeria Guerra Navarro, Ryan Dewan, Nicole Favre, Mohamed Elrakhawy, et al.
- PMID
- 42573608
- DOI
- 10.1007/s00405-026-10491-7
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 16 August 2026): Teprotumumab linked to increased sensorineural hearing loss risk
Abstract
PURPOSE: To evaluate the association between teprotumumab use and hearing loss in hyperthyroid patients using real-world, population-level data. 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 teprotumumab and a control group of patients not treated with teprotumumab. 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 teprotumumab 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: A total of 2,164 patients were included (1,082 per cohort; mean age 55.9 years, SD = 14.6), with 793 (73.3%) female and 258 (23.8%) male in each group. Sensorineural hearing loss occurred in 154 (14.2%) of Teprotumumab users versus 51 (4.7%) of controls (P < .001), corresponding to a relative risk (RR) of 3.15 (95% CI: 2.31-4.27). Unspecified hearing loss was reported in 78 (7.2%) Teprotumumab patients versus 47 (4.3%) controls (P = .006; RR = 1.66; 95% CI: 1.17-2.36). Conductive and mixed hearing loss could not be reliably analyzed due to small sample sizes (N < 10 per group). CONCLUSION: Teprotumumab use is associated with a significantly increased risk of sensorineural and unspecified hearing loss in patients with hyperthyroidism. These findings support routine audiologic monitoring during treatment and highlight the need for prospective studies to investigate underlying mechanisms and preventative strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.