Does Tepezza cause hearing loss?

Hearing loss is a common side effect of Tepezza (teprotumumab-trbw). In clinical studies of 170 patients with thyroid eye disease, hearing impairment occurred in 10% of patients treated with Tepezza compared to 0% of those taking a placebo. Types of hearing impairment that were reported include:

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

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 of hearing loss from Tepezza

• 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.

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.

Why does Tepezza cause hearing loss?

Tepezza is an insulin-like growth factor-1 receptor (IGF-1R) inhibitor. IGF-1 helps protect the hair cells in the inner ear 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.

If you notice any new changes in your hearing or ringing in your ears, contact your doctor right away.