Thyroid eye disease, 53 thousand Italians affected. New drugs on the way

Roma – 53 thousand people in Italy are affected, with an estimated 8,9 cases per 10 thousand inhabitants. Thyroid Eye Disease (TED) is a complex autoimmune disease “poorly defined and known” within the medical community, which mainly affects women and can still manifest itself in conjunction with or independently of thyroid dysfunction.

According to literature data, approximately 33% of patients have a moderate-severe degree, while 2% have a degree so severe that they are at risk of vision loss.

In the last five years, health research in general has accelerated in terms of innovation and TED, according to experts, is also destined for a “significant implementation” in the near future.

Despite this, there is still a “little knowledge” about this pathology, which would require a “more multidisciplinary” approach. This was discussed in Rome during an event organized by Motore Sanità at Palazzo Baldissimi.

Several experts were present, who discussed in particular the management of the disease in Lazio, including the president of the Italian Association of Ophthalmologists (AIMO), Dr. Alessandra Balestrazzi, Dr. Francesco Quaranta Leoni, scientific director of AIMO for Ophthalmoplastic Surgery, and Professor Gustavo Savino, director of the UO Ocular Oncology department and Thyroid Ophthalmopathy Clinic of the Gemelli Polyclinic in Rome.

“We talked about the problem of TED in Lazio - Quaranta Leoni said during an interview with the Management - therefore to increase awareness of this pathology and to create centers in which patients can converge and are managed by experts, with advanced clinical and surgical skills, who can work with endocrinologists and possibly with specialists to optimize the services offered to the patient.

We are now waiting for the approval of new drugs that can change the scenario in the treatment of these patients, drugs that have already been approved in the United States since 2020".

TED transforms the tissues of the orbit, leading to clinical signs and symptoms that severely impact the health and quality of life of patients such as inflammation, proptosis (bulging eye), diplopia (double vision), eyelid retraction, pain. In extreme cases, there is damage to the optic nerve, severe impairment of visual function, corneal damage and even loss of vision.

“From a surgical point of view,” Quaranta Leoni then underlined, “it is essential that there are experts in the field capable of managing the patient 360 degrees from the point of view of orbital surgery, decompression, strabismus and eyelid surgery.”

TED, the expert told Dire, is a disease "relatively rare and in any case less rare than other diseases that are often talked about, such as Crohn's disease or myasthenia gravis. It has an incidence of about 9 cases per 10 thousand patients, but those who deal with this pathology in practice know that the number of patients affected is actually higher.

TED is a disease that affects the quality of life of patients, who often have a problem of acceptance, but also from the point of view of the costs for surgical therapies, sometimes complex - concluded the expert - which fall on the patient himself and on the national health system".

Among the critical points of the pathology, it emerged from the meeting organized by Motore Sanità, a first element is represented by the poor knowledge of the disease that causes a high diagnostic difficulty, especially in the initial stages, hindering a rapid and appropriate management of patients.

This aspect, associated with the lack of specific national registries for this disease, places in the precise estimate of patients affected by TED in the Italian context. Another critical element is the multi-professional interest that characterizes TED: in particular in terms of specialist skills between endocrinology and ophthalmology, which requires an effective multidisciplinary network care response, capable of overcoming current barriers.

“To date - the experts finally highlighted - it is essential in this perspective to survey and reorganize the care network by establishing which and how many highly specialized centers can have the competence to review the appropriate pathways, creating connections with the centers with lower intensity of care and with the territory”. A good current example is represented by the EUGOGO network (European Group On Graves Orbitopathy).