Ophthalmology · 2026
THRIVE: A Phase 3, Randomized, Double-Masked, Placebo-Controlled Study of Veligrotug for Active Thyroid Eye Disease.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеКлиническое исследование III фазыНазвание и аннотация: Перевод в очереди
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Yen Michael T, Cockerham Kimberly, Saeed Peerooz, Leibowitz Steven, Mudumbai Raghu C, Schittkowski Michael P, Lee Vickie, Abrams Jody, Turbin Roger E, Pío-Rendón Julián Bermúdez, Bertelmann Eckart, Eade Edwina, Nijhawan Navdeep, Pérez-López Marta, Sales-Sanz Marco, Zhang-Nunes Sandy, Kossler Andrea L, Pajak Ashley, Narvekar Abhijit, Tripuraneni Radhika, Garrido-Hermosilla Antonio Manuel, THRIVE Study Group
Аннотация
PURPOSE: Thyroid eye disease (TED) is a debilitating autoimmune disease with significant unmet needs. This study's objective was to assess the efficacy and safety of veligrotug, a full antagonist monoclonal antibody to the insulin-like growth factor-1 receptor, in patients with active TED.
DESIGN: Veligrotug was assessed in THRIVE, a global, multicenter, randomized, double-masked, placebo-controlled phase 3 trial.
PARTICIPANTS: Adult patients with moderate-to-severe active TED (onset ≤ 15 months, proptosis ≥ 3 mm above normal, and clinical activity score [CAS] ≥ 3) received either veligrotug or placebo.
METHODS: Patients were randomized 2:1 to receive 10 mg/kg veligrotug or placebo administered every 3 weeks for a total of 5 IV infusions.
MAIN OUTCOME MEASURES: The primary end point at week 15 was the proptosis responder rate (PRR; ≥ 2-mm reduction by Hertel exophthalmometry) or overall responder rate (ORR; PRR and ≥ 2-point reduction in CAS), depending on geographic region. Efficacy and safety were assessed through week 52.
RESULTS: A total of 113 patients received veligrotug (n = 75) or placebo (n = 38). Baseline characteristics were balanced between the 2 arms. Improvements were observed at week 3, with a significantly greater response at week 15 for veligrotug versus placebo (P < 0.001) across all primary and secondary end points including: PRR by Hertel, 70% versus 5%; PRR by magnetic resonance imaging (MRI) or computed tomography (CT), 71% versus 9%; ORR, 67% versus 5%; mean proptosis reduction, 2.90 mm versus 0.48 mm (Hertel) and 2.96 mm versus 0.58 mm (MRI/CT); diplopia improvement, 59% versus 20%; and diplopia resolution, 49% versus 12%. At week 52, 70% of initial responders maintained proptosis response. Veligrotug was generally well tolerated, with a 4% treatment discontinuation rate. Most adverse events were mild and resolved, with no serious treatment-related adverse events and no changes in the safety profile through week 52.
CONCLUSIONS: A 5-infusion course of veligrotug administered over 12 weeks was generally well tolerated and led to rapid and significant improvements in diplopia, proptosis, and disease activity, with a durable response through week 52. Veligrotug may become a promising new treatment option for active TED.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
DESIGN: Veligrotug was assessed in THRIVE, a global, multicenter, randomized, double-masked, placebo-controlled phase 3 trial.
PARTICIPANTS: Adult patients with moderate-to-severe active TED (onset ≤ 15 months, proptosis ≥ 3 mm above normal, and clinical activity score [CAS] ≥ 3) received either veligrotug or placebo.
METHODS: Patients were randomized 2:1 to receive 10 mg/kg veligrotug or placebo administered every 3 weeks for a total of 5 IV infusions.
MAIN OUTCOME MEASURES: The primary end point at week 15 was the proptosis responder rate (PRR; ≥ 2-mm reduction by Hertel exophthalmometry) or overall responder rate (ORR; PRR and ≥ 2-point reduction in CAS), depending on geographic region. Efficacy and safety were assessed through week 52.
RESULTS: A total of 113 patients received veligrotug (n = 75) or placebo (n = 38). Baseline characteristics were balanced between the 2 arms. Improvements were observed at week 3, with a significantly greater response at week 15 for veligrotug versus placebo (P < 0.001) across all primary and secondary end points including: PRR by Hertel, 70% versus 5%; PRR by magnetic resonance imaging (MRI) or computed tomography (CT), 71% versus 9%; ORR, 67% versus 5%; mean proptosis reduction, 2.90 mm versus 0.48 mm (Hertel) and 2.96 mm versus 0.58 mm (MRI/CT); diplopia improvement, 59% versus 20%; and diplopia resolution, 49% versus 12%. At week 52, 70% of initial responders maintained proptosis response. Veligrotug was generally well tolerated, with a 4% treatment discontinuation rate. Most adverse events were mild and resolved, with no serious treatment-related adverse events and no changes in the safety profile through week 52.
CONCLUSIONS: A 5-infusion course of veligrotug administered over 12 weeks was generally well tolerated and led to rapid and significant improvements in diplopia, proptosis, and disease activity, with a durable response through week 52. Veligrotug may become a promising new treatment option for active TED.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.