Tepezza for Thyroid Eye Disease
Understanding TED and Why Tepezza Is Used
This section explains what happens in TED and how Tepezza helps calm the disease process so you can see and feel better.
TED is an autoimmune condition that inflames the tissues and muscles around the eyes. Eyelids can pull back, eyes may bulge, redness and burning can increase, and double vision may appear. In severe cases, swelling can press on the optic nerve and threaten sight.
TED usually starts with an active phase when inflammation rises, then shifts to an inactive phase when the disease quiets down. Tepezza works best during the active phase. We will check which phase you are in and whether now is the right time to start treatment.
Tepezza, also called teprotumumab-trbw, is a targeted medicine that blocks a key signal that drives TED. It is not a steroid. It treats the cause of the swelling behind the eyes, not just the symptoms.
Tepezza blocks the insulin-like growth factor 1 receptor in the tissues behind the eyes. When TED is active, this receptor turns on and causes inflammation and swelling of the muscles and fat around the eyes. By blocking this signal, Tepezza reduces swelling at the source.
In clinical studies, many patients had meaningful reduction in eye bulging and improvement in double vision. Patients also reported less pain, redness, tearing, and pressure behind the eyes.
Tepezza is considered for patients with active, moderate to severe TED. It may help people with Graves disease and, in select cases, other thyroid autoimmune conditions when TED is active. We tailor the decision to your exam findings and health history.
You may see unofficial or incorrect drug names for TED treatments on the internet. There is no FDA approved TED medicine called Topaa Topaza. Tepezza is the approved infusion therapy for TED. If you have questions about anything you read, we are happy to review it with you.
Before You Start: Evaluation and Safety Checks
We perform a careful exam and review your health history to confirm that Tepezza is safe and appropriate for you.
We use standardized scores to measure how active and how severe your TED is. These scores guide timing and help set clear expectations for improvement.
Tepezza can harm an unborn baby. If you are pregnant, planning pregnancy, or breastfeeding, we will discuss risks and options. Patients who can become pregnant should use reliable birth control during treatment and for a period after the last dose. We will give specific guidance for your situation.
Some patients notice changes in hearing or ringing in the ears during treatment. Tell us right away if you notice any change. We may arrange baseline and follow up hearing tests as needed.
Tepezza can raise blood sugar, especially in patients with diabetes or prediabetes. We will coordinate with your primary doctor or endocrinologist and monitor readings during treatment.
Tepezza may worsen conditions like Crohn disease or ulcerative colitis. If you have IBD, we will review your symptoms and coordinate with your gastroenterologist to help prevent flares.
Stable thyroid levels support better outcomes. We will check your thyroid function and work with your endocrinologist to keep your levels steady during treatment.
Bring a full list of your medicines and supplements. We will review possible interactions and any allergy history before the first infusion.
Smoking makes TED worse and can limit how well treatment works. If you smoke, we will support you with resources to help you quit.
How Tepezza Treatment Works
This section outlines how Tepezza is given, how long treatment lasts, and what to expect at each visit.
Tepezza is given by intravenous infusion in your arm. A nurse monitors you throughout the visit. Most infusions take about 60 to 90 minutes.
The standard course is eight infusions. The first dose is lower, and later doses are higher. Infusions are given every three weeks, so treatment usually takes about 21 weeks.
Infusions are performed in an outpatient infusion center. We coordinate appointments and choose a location that is convenient for you. No hospital stay is needed.
Eat a light meal, stay hydrated, and take your usual medicines unless we instruct otherwise. Wear comfortable clothing. Bring any blood sugar logs if you track them.
You will have a brief check in, an IV will be started, and the infusion will run while you are seated. A clinician will watch for any symptoms and can pause or slow the infusion if needed.
Most people feel well and can resume normal activity the same day. Mild fatigue or headache can occur. Call us if anything concerns you.
If you have a significant side effect or illness, we may adjust the timing or dose. We will guide you on how to safely continue treatment.
Possible Side Effects and How We Monitor You
Side effects are usually manageable. We will explain what to watch for and how we will keep you safe.
Common effects include muscle cramps, nausea, diarrhea, fatigue, hair thinning, changes in taste, dry skin, and changes in menstrual periods. These are often mild and improve after treatment ends.
We may ask you to check blood sugar more often if you have diabetes or risk factors. Share high readings with us so we can adjust your care plan.
Some patients notice muffled hearing or ringing in the ears. Report symptoms right away. We may arrange hearing tests and adjust treatment if needed. Some changes improve after treatment, though not always.
Nausea or diarrhea can occur. If you have IBD, we will watch closely for flares and coordinate with your gastroenterologist.
A small number of patients have reactions during the infusion, such as headache, high blood pressure, or shortness of breath. The infusion team can manage these quickly.
Call if you have vision changes, severe headache, severe abdominal pain, chest pain, shortness of breath, sudden hearing changes, or very high blood sugar readings.
Serious allergic reactions and severe hearing problems are rare but possible. We review these risks before you begin and monitor during each infusion.
What to Expect During and After Treatment
Here is what many patients experience from the first infusion through long term follow up.
Some patients notice less redness, swelling, or eye discomfort within a few weeks. Reduction in eye bulging often becomes clearer after several infusions. The full effect is usually measured by the end of the eighth infusion.
Improvements can last months or years after treatment. TED often becomes less active over time. We will continue regular checkups to track stability.
Not everyone improves fully. If symptoms remain, we will discuss options such as eyelid surgery, eye muscle surgery, or orbital decompression once TED is inactive.
We schedule follow up visits during and after treatment to check vision, eye pressure, alignment, and comfort. We also coordinate with your endocrinologist to keep thyroid levels stable.
Good sleep, healthy diet, no smoking, and steady thyroid levels support healing. Use artificial tears for surface comfort and protect your eyes from wind and sun.
If double vision persists, we may use prism glasses or targeted exercises. These tools can improve comfort while your condition settles.
Insurance, Cost, and Access
Our team helps you understand coverage and removes barriers so treatment can begin as soon as it is safe to do so.
Many insurance plans cover Tepezza for active, moderate to severe TED. We verify benefits and obtain prior authorization when needed. We begin this process early.
Programs may help with copays and financial counseling. We will connect you to available resources and guide you through applications.
We work with your endocrinologist, the infusion center, and your insurer to keep scheduling and approvals on track. Our goal is a smooth experience from start to finish.
We provide clear estimates based on your plan and explain any expected out of pocket costs before treatment starts.
If you live outside our usual networks, we will help find an infusion site that works for you. Patients visit us from Manchester and nearby communities such as East Hartford, South Windsor, and Vernon.
Infusions are every three weeks. If life events come up, we will help you stay as close to the schedule as possible for best results.
Frequently Asked Questions
Here are answers to common questions about Tepezza and care at our practice.
Most patients can drive after visits. For the first infusion, consider arranging a ride in case you feel tired or have a mild headache.
Tepezza treats the active inflammation and can lead to lasting improvements. It does not cure the underlying autoimmune condition. Keeping thyroid levels steady and not smoking lowers the chance of future flares.
Contact us as soon as possible. We will adjust the schedule and keep you on track. Missing one infusion usually does not mean starting over.
Tepezza is designed for active TED, which is usually before surgery. If your TED is inactive after surgery, Tepezza may not add benefit. We will review your case and advise you.
Many plans that approve Tepezza cover the full course, though details vary. We clarify benefits before you start.
Often yes, but it depends on what you take. Bring your full medication list. We will review for safety and coordinate with your other doctors.
Many patients use Tepezza without steroids. If you are on steroids, we may taper them under medical guidance once it is safe.
We welcome patients from the Greater Hartford–East Hartford–Middletown area, including Hartford, Tolland, and Middlesex Counties, and from the Springfield region in Massachusetts.
We Are Here to Help
If you have thyroid eye disease, our team at ReFocus Eye Health Manchester will evaluate your condition, explain your options, and guide you through Tepezza therapy when it is right for you.
I noticed that the office is cleaner and brighter. Dr. Cavanaugh was very professional and very personal. Tim was great as well. It was a very pleasant visit.
Janet Platt
They were able to get us in so quickly. The woman on the phone was so friendly and helpful, and the doctor was AWESOME with my 7 year old. Absolutely recommend.
Megan Hall
Dr. Goldstein was personable and seemed very well qualified. The exam time was good and he nicely explained the procedures. His tech was very pleasant also.
Lynda Seid
Not rushed. That was the best part of the visit. Everybody there was very nice. I have no complaints and I will see you guys in a year Tata for now.
Susan Andruskiewicz
Knowledgeable and friendly doctors and staff. Short wait time, even with a busy waiting room. Online check-in is great to save time.
Rayah Martin
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Tuesday: 8AM-5PM
Wednesday: 8AM-5PM
Thursday: 8AM-5PM
Friday: 8AM-5PM
Saturday: Closed
Sunday: Closed