Does Tepezza cause hearing loss?

Yes, hearing loss is a known side effect of Tepezza (teprotumumab-trbw). Clinical studies have shown that hearing impairment occurs in some patients receiving this medication for thyroid eye disease (TED).

How Common Is Hearing Loss with Tepezza?

In clinical trials involving 170 patients with TED:

• 10% of patients treated with Tepezza experienced hearing impairment.
• 0% of patients receiving a placebo reported hearing issues.

Types of Hearing Impairment Reported:

• Hearing loss
• Eustachian tube dysfunction
• Tinnitus (ringing in the ears)
• Hyperacusis (higher sensitivity to sounds)
• Hypoacusis (lower sensitivity to sounds)
• Autophony (enhanced perception of your own voice or noises)

FDA Warning on Hearing Loss

Although Tepezza was approved in 2020, the warning about hearing impairment was added to the prescribing information by the FDA in July 2023. The warning states that in some cases hearing loss from Tepezza can be permanent.

Additional Studies on Hearing Loss and Tepezza

Research suggests that hearing impairment may be more common than initially reported:

• In a small study of 28 patients who took Tepezza, 46% of them complained of hearing symptoms after 4 infusions. Most patients reported an ear plugging sensation or muffled hearing.
• Another small study of 27 patients who took an average of 4 infusions showed that almost 82% of them developed new hearing symptoms. These symptoms included ringing in the ears, hearing loss, ear plugging, and autophony. At about 39 weeks, only 45.5% of patients who complained of hearing loss improved.

Why Does Tepezza Cause Hearing Loss?

Tepezza is an insulin-like growth factor-1 receptor (IGF-1R) inhibitor. IGF-1 helps protect inner ear hair cells from damage caused by noise and medication toxicity. By blocking IGF-1, Tepezza likely causes the ear hair cells to be more susceptible to damage. This results in hearing loss.

What Should You Do If You Experience Hearing Changes?

It’s important to weigh the risks and benefits of Tepezza before starting it. Your doctor will check your hearing before, during, and after treatment with Tepezza. If you notice any new changes in your hearing or ringing in your ears, contact your doctor right away.