Insulin-like Growth Factor 1-Receptor Inhibitors in Thyroid Eye Disease: Developing a Consensus to Address and Manage Hearing-Related Impairment

2.50 CME
120 MINS
$0 FEE
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Insulin-like Growth Factor 1-Receptor Inhibitors in Thyroid Eye Disease: Developing a Consensus to Address and Manage Hearing-Related Impairment


Provider Statement

This continuing medical education activity is provided by Vindico Medical Education

Support Statement

This activity is supported by an educational grant from Horizon Therapeutics USA, Inc.

Activity Description

Thyroid eye disease (TED) is an autoimmune disorder that is believed to result from the stimulation of several receptors located in the orbital fibroblasts. It is frequently misdiagnosed, due to both the heterogeneity of clinical presentation and lack of understanding of the relationship between TED and hyperthyroidism. Misdiagnosis can place patients at risk, as management is most effective during the initial active phase of the disease. However, differential diagnosis can be achieved with the assistance of imaging, and early treatment may limit disfigurement and reduce vision loss. Ophthalmologists, endocrinologists, and other clinicians who care for patients with TED should be knowledgeable about the conventional and new treatments available as well as how to apply this information to practice. In this CME activity, experts in the field will explore conventional and new treatment options, including teprotumumab, the first and only medical agent approved by the US Food and Drug Administration for the treatment of TED. The panel will explore the potential adverse effects associated with teprotumumab treatment, particularly hearing impairment, and will specifically address appropriate auditory testing and monitoring of patients being treated with teprotumumab.

Target Audience

The intended audience for this activity is endocrinologists, ophthalmologists, and other health care professionals involved in the management of patients with thyroid eye disease.

Learning Objectives

Upon successful completion of this activity, participants should be better able to:

  • Review the efficacy and safety of conventional and new treatments for thyroid eye disease.
  • Assess the evidence on physiological mechanisms that may lead to adverse events in patients receiving insulin-like growth factor 1–receptor (IGF-1R) inhibitor therapy for the treatment of thyroid eye disease.
  • Describe best practices that can be incorporated to improve the testing and monitoring of patients prescribed IGF-1R inhibitor therapy to proactively address potential safety concerns.
  • Outline practices and procedures that can improve the multidisciplinary management of hearing-related adverse effects associated with IGF-1R inhibitor therapy for thyroid eye disease.

Activity Chair

Raymond S. Douglas, MD, PhD
Professor of Surgery
Division of Ophthalmology
Director, Orbital and Thyroid Eye Disease Program
Cedars-Sinai Medical Center
Los Angeles, CA


Kimberly Cockerham, MD, FACS
Neuro-Ophthalmology, Orbital Disease and Oculofacial Restoration
Private Practice: Senta Clinic, San Diego, CA and Central Valley Eye Medical Group
Stockton, CA
Adjunct Clinical Associate Professor,
Byers Eye Institute at Stanford School of Medicine
Palo Alto, CA

Marlan R. Hansen, MD, FACS
Brian F. McCabe Distinguished Chair and DEO
Professor, Departments of Otolaryngology-Head and Neck Surgery, Neurosurgery, and Molecular Physiology and Biophysics
Co-Director, Institute of Clinical and Translational Science
University of Iowa
Iowa City, IA

Andrea Lora Kossler, MD, FACS
Director, Oculofacial Plastic & Orbital Surgery
Assistant Professor of Ophthalmology
Byers Eye Institute at Stanford University School of Medicine
Palo Alto, CA

Elias Michaelides, MD
Associate Professor
Rush University Medical Center
Chicago, IL

Erin M. Shriver, MD, FACS
Clinical Professor
Jim O’Brien Gross and Donnita Gross Chair in Ophthalmology
Departments of Ophthalmology and Visual Sciences and Otolaryngology
University of Iowa
Iowa City, IA


Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP


Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

Vindico Medical Education designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning and Self-Assessment requirements for the American Board of Ophthalmology’s Continuing Certification program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting credit.

Upon successful completion, learners who opt-in by providing their ABO ID and DOB (MM/DD) will earn credits equivalent to the amount of CME credits claimed for the activity.

This enduring material is approved for 1 year from the date of original release, November 10, 2021, to November 9, 2022.

How to Participate in This Activity and Obtain CME Credit

To participate in this CME activity, you must read the objectives, answer the polling and pretest questions, view the content, and complete the posttest and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 3 of the 4 posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s)™ certificate.


Vindico Medical Education adheres to the Accreditation Council for Continuing Medical Education’s (ACCME) Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a continuing education activity, including faculty, planners, reviewers, or others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Activity Chair and Faculty report the following relationship(s)

Kimberly Cockerham, MD, FACS
Consultant: Horizon, Viridian Therapeutics
Speaker for Ineligible Company: Horizon

Raymond S. Douglas, MD, PhD
Consultant: Horizon, Viridian Therapeutics

Marlan R. Hansen, MD, FACS
Employee or Executive Role: iotaMotion, Inc.*

Andrea Lora Kossler, MD, FACS
Consultant: Horizon, Immunovant
Independent Research Contractor: Horizon

Elias Michaelides, MD
No relevant financial relationships to disclose.

Erin M. Shriver, MD, FACS
Advisor: Horizon
Consultant: Horizon

Reviewer reports the following relationship(s)

Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP
No relevant financial relationships to disclose.

Vindico Medical Education staff report the following relationship(s)

No relevant financial relationships to disclose.

Signed disclosures are on file at Vindico Medical Education, Office of Medical Affairs and Compliance.

*The contents of this activity are not related to the business lines or products of the employer.

Unlabeled and Investigational Usage

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of US Food and Drug Administration (FDA)–approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage. All activity participants will be informed if any speakers/authors intend to discuss either non–FDA-approved or investigational use of products/devices.

Copyright Statement

Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2021 Vindico Medical Education. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of Vindico Medical Education continuing medical education activities does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.

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