Raymond Douglas, MD, PhD, Unveils Research on Six-Week Teprotumumab Dosing to Help Protect Hearing

LOS ANGELES, Oct. 12, 2026 /PRNewswire/ -- Raymond Douglas, MD, PhD, a lead scientist behind the first FDA-approved treatment for thyroid eye disease (TED) and a 2026 ASOPRS Outstanding Contribution Award recipient, presented research at the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) 57th Annual Fall Scientific Symposium pointing to a new dosing approach for the patients most at risk of hearing side effects. The study found that spacing teprotumumab infusions six weeks apart, rather than the standard three, may protect hearing in TED patients who already have hearing loss, without giving up the benefits of treatment. The symposium took place October 8–9, 2026, at the Hyatt Regency New Orleans.

Teprotumumab (TEPEZZA®) is the first FDA-approved medicine for TED, an autoimmune condition that can cause eye bulging, inflammation, double vision, and changes in appearance. The FDA-approved regimen is eight infusions given three weeks apart.

Hearing-related side effects have been reported in about 10% of patients in the phase 2 and phase 3 clinical trials, and in as many as 50% of "high-risk" patients who have hearing problems before treatment begins. There has been no established protocol designed specifically for TED patients with existing hearing loss. To help close that gap, Dr. Douglas and his team studied whether a longer interval between infusions could better protect these patients' hearing.

The longer interval made a measurable difference. Patients on a six-week schedule were more than 60% less likely to experience a decline in their hearing. At 24 weeks, nearly half of patients on the standard three-week schedule (45%, 9 of 20) showed a clinically significant decline on formal audiometry, compared with about one in six on the six-week schedule.

Importantly, the longer interval did not appear to reduce the effectiveness of treatment. The two groups showed no significant differences in improvement in inflammation, eye bulging, or double vision.

"When we began studying the biology of thyroid eye disease decades ago, there was no approved treatment to offer patients. Today teprotumumab has changed what's possible for them, and our work isn't finished," said Dr. Raymond Douglas. "Patients who already live with hearing loss have told us this side effect is their greatest concern. These results suggest that for this higher-risk group, spacing infusions further apart may help protect hearing without giving up the benefits of treatment. It is humbling to keep finding ways to make these therapies better and safer for the patients who trust us with their care. This work is also an important reminder to monitor hearing and other potential side effects closely, before and throughout treatment."

Additionally, Dr. Douglas and longtime collaborator Terry J. Smith, MD, were presented with this year's ASOPRS Outstanding Contribution Award for their years of research on thyroid eye disease. The award recognizes members whose project-based work makes a significant contribution to the Society or the field, beyond service and committee work. Dr. Douglas began his TED research during his fellowship at UCLA under Drs. Robert Goldberg and Terry Smith, launching more than two decades of work on the IGF-1R pathway that contributed to the development of teprotumumab.

About the Study

Dr. Douglas and his team reviewed 38 consecutive TED patients treated with teprotumumab, all of whom had hearing loss confirmed by formal audiometry before their first infusion. Patients with existing hearing loss were offered the option of the six-week schedule, resulting in two groups similar in age and sex:

• Six-week schedule: 18 patients (13 women, 5 men; average age 57)
• Standard three-week schedule: 20 patients (16 women, 4 men; average age 57)

Each patient's hearing was tested with audiometry, the gold standard for measuring hearing, before treatment and again at 24 weeks. A clinically significant change was defined using American Speech-Language-Hearing Association (ASHA) criteria. The team also tracked whether treatment remained effective by measuring inflammation, eye bulging, and double vision.

The findings add to growing evidence that hearing should be tested before teprotumumab begins and monitored throughout treatment, and they point to a longer infusion interval as a promising option for patients at higher risk. Because this was a retrospective study of a relatively small group, the researchers note that larger prospective studies are needed to confirm the results.

Presentation Details

• Title: Extended 6-Week Teprotumumab Interval Reduces Audiometric Deterioration Compared to a Standard 3-Week Interval Schedule
  
  
• Presenting Author: Shoaib Ugradar, MD
  
  
• Authors: Raymond S Douglas, MD, PhD, Shoaib Ugradar, MD, Anthony Wong, MD, Pershanjit Raika, MBBS, Raymond N Douglas, Tasmin Sazzad, Madison Chan
  
  
• Meeting: ASOPRS 57th Annual Fall Scientific Symposium
  
  
• Date/Time: October 8-9, 2026
  
  
• Location: Hyatt Regency New Orleans, New Orleans, Louisiana

About Raymond Douglas, MD, PhD

Raymond Douglas, MD, PhD, is a board-certified oculoplastic surgeon and internationally recognized thyroid eye disease specialist based in Beverly Hills, California, with practices in Southern California and Las Vegas. He was one of the lead scientists in the development of teprotumumab and served as principal investigator of the international clinical trials that led to its FDA approval, and he was the first physician in the world to treat patients with the medicine after approval. Dr. Douglas earned his medical degree and a doctorate in immunology from the University of Pennsylvania and completed fellowship training in orbitofacial plastic and reconstructive surgery at the UCLA Stein Eye Institute.

Learn more at raymonddouglasmd.com.

References

1. Smith TJ, et al. Teprotumumab for Thyroid-Associated Ophthalmopathy. N Engl J Med. 2017;376(18):1748-1761. doi:10.1056/NEJMoa1614949
   
   
2. Douglas RS, et al. Teprotumumab for the Treatment of Active Thyroid Eye Disease. N Engl J Med. 2020;382(4):341-352. doi:10.1056/NEJMoa1910434
   
   
3. Keen JA, et al. Frequency and Patterns of Hearing Dysfunction in Patients Treated with Teprotumumab. Ophthalmology. 2024;131(1):30-36. doi:10.1016/j.ophtha.2023.08.001

TEPEZZA® is a registered trademark of its owner. This research was not presented as an endorsement of any change to the FDA-approved dosing schedule.

Patients should not change their treatment schedule on their own. Anyone receiving or considering teprotumumab should talk with their physician about hearing monitoring and the dosing approach that is right for them.

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SOURCE Dr. Raymond Douglas, MD, PhD