What is your approach to audiometric monitoring for patients on teprotumumab and how do you discuss the possibility of irreversible hearing loss with your patients?

I have set up a connection with our institution’s ENT and audiometry service to do a baseline test for any patient who is a candidate for teprotumumab. If the patient already has abnormalities in the high and ultrahigh frequencies, would not proceed to treatment. Would also repeat the test if the patient develops hearing issues, fullness, or tinnitus.

I explain the possibility of hearing issues, including a permanent hearing test, and share the current data with the patient. I would review the overall benefits as well and discuss the alternatives as usual with the patient to make a mutual decision.