{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:09:54Z","timestamp":1790057394855,"version":"4.0.1"},"reference-count":22,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Horizon Therapeutics plc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Limited data exist on US referral\/management patterns for moderate-to-severe thyroid eye disease (TED), a disabling condition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>US ophthalmologists and endocrinologists experienced in treating TED provided medical record data of moderate-to-severe TED patients and information on referral\/treatment practices. Data on signs\/symptoms, medical\/surgical treatments, treatment response, and referral history were collected. Moderate and severe cases were stratified to interrogate treatment\/practice differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 181 physicians provided data on 714 patients (49.4\u2005\u00b1\u200513.6 years old, 65% women, 14% severe disease). Reporting physicians diagnosed 55% of patients themselves and solely managed 37% of cases, with similar referral\/comanagement patterns between moderate and severe cases. Topical therapies included lubricating (79%) and glucocorticoid (39%) eye drops. Systemic therapies included oral glucocorticoids (36%), IV glucocorticoids (15%), and rituximab and\/or tocilizumab (12%). Few patients underwent orbital radiation (4%) or surgical intervention (4%). IV glucocorticoids (33% vs. 12%), biologics (26% vs. 10%), orbital radiation (11% vs. 3%), and ocular surgery (12% vs. 3%) were used more often in severe versus moderate cases (all P\u2005&amp;lt;\u20050.001). However, severe disease was less responsive to therapy (very responsive to therapy: 28% vs. 49%, P\u2005&amp;lt;\u20050.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Participating physicians were primarily responsible for just over one-half of TED diagnoses, but solely treated &amp;lt;40% of patients. Severe TED was treated more often with surgery and systemic immunologic therapies than moderate disease, but was less likely to respond to treatment. These results reinforce that moderate-to-severe TED is difficult to treat with an unmet medical need in the United States.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvaa140","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T03:44:40Z","timestamp":1601005480000},"source":"Crossref","is-referenced-by-count":8,"title":["Trends in Treatment of Active, Moderate-to-Severe Thyroid Eye Disease in the United States"],"prefix":"10.1210","volume":"4","author":[{"given":"Yao","family":"Wang","sequence":"first","affiliation":[{"name":"Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4199-4844","authenticated-orcid":false,"given":"Lissa","family":"Padnick-Silver","sequence":"additional","affiliation":[{"name":"Horizon Therapeutics plc, Lake Forest, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4288-2852","authenticated-orcid":false,"given":"Megan","family":"Francis-Sedlak","sequence":"additional","affiliation":[{"name":"Horizon Therapeutics plc, Lake Forest, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"Holt","sequence":"additional","affiliation":[{"name":"Horizon Therapeutics plc, Lake Forest, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Foley","sequence":"additional","affiliation":[{"name":"Horizon Therapeutics plc, Lake Forest, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Massry","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond S","family":"Douglas","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"issue":"3","key":"2020120503065999700_CIT0001","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/S0002-9394(14)70276-4","article-title":"Clinical features of Graves\u2019 ophthalmopathy in an incidence cohort","volume":"121","author":"Bartley","year":"1996","journal-title":"Am J Ophthalmol."},{"key":"2020120503065999700_CIT0002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000475944","article-title":"Clinical 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