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Consequently, patients suffer to a variable extent from periocular swelling, exophthalmos, and fibrosis of the eye muscles and thus restrictive motility impairment with double vision. In recent decades, therapeutic approaches have mainly comprised immunosuppressive treatments and antithyroid drug therapy for hyperthyroidism to inhibit thyroid hormone production. With the recognition that TRAb also activates an important growth factor receptor, IGF1R (insulin-like growth factor 1 receptor), biological agents have been developed. Teprotumumab (an inhibitory IGF1R\n          antibody) has already been approved in the USA and the therapeutic effects are enormous, especially with regard to the reduction of exophthalmos. Side effects are to be considered, especially hyperglycaemia and hearing loss. It is not yet clear whether the autoimmune reaction (development of the TRAb\/attraction of immunocompetent cells) is also influenced by anti-IGF1R inhibiting agents. Recurrences after therapy show that the inhibition of antibody development must be included in the therapeutic concept, especially in severe cases.<\/jats:p>","DOI":"10.1055\/a-2186-5548","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T03:41:55Z","timestamp":1696563715000},"page":"48-68","source":"Crossref","is-referenced-by-count":5,"title":["Current Therapeutic Approaches for Graves\u02bc Orbitopathy \u2013 are Targeted Therapies the Future?"],"prefix":"10.1055","volume":"241","author":[{"given":"Anja","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareile","family":"St\u00f6hr","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina-Eva","family":"G\u00f6rtz","sequence":"additional","affiliation":[{"name":"Labor f\u00fcr Molekulare Augenheilkunde, Universit\u00e4t Duisburg-Essen, Duisburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Gulbins","sequence":"additional","affiliation":[{"name":"Labor f\u00fcr Molekulare Augenheilkunde, Universit\u00e4t Duisburg-Essen, Duisburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"M\u00f6ller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Stoffwechsel, Universit\u00e4tsklinikum Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Fuehrer-Sakel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Stoffwechsel, Universit\u00e4tsklinikum Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Oeverhaus","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Essen, Deutschland"},{"name":"Gemeinschaftspraxis Dres. 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