TED typically progresses through two phases:
This distinction matters for treatment planning, since not every therapy has historically been studied — or approved — for use in both phases.
Diagnosis usually involves a combination of:
Historically, TED management included corticosteroids (to reduce inflammation), orbital radiation, and surgery (orbital decompression, eye muscle surgery, or eyelid surgery) for structural changes. In recent years, targeted biologic drugs have become available that address the underlying disease process rather than just symptoms.
Two FDA-approved options are outlined below.
Manufacturer: Amgen (originally Horizon Therapeutics)
Type: IGF-1R (insulin-like growth factor-1 receptor) inhibitor antibody
FDA approval: 2020 for active TED; label expanded in 2023 to include chronic TED
How it works: Tepezza blocks IGF-1R, a receptor believed to drive the inflammation and tissue expansion behind TED symptoms.
How it’s given: IV infusion — 8 total infusions, administered once every 3 weeks (about 21 weeks of treatment).
What it’s shown to help with: Reduction in proptosis (eye bulging) and improvement in diplopia (double vision).
Common side effects:
Other considerations: Not recommended during pregnancy; hearing should be monitored before and during treatment. Tepezza can worsen inflammatory bowel disease (Crohn’s disease or ulcerative colitis) symptoms, even in patients without a prior IBD diagnosis, so IBD history should be discussed with a prescribing physician.
Manufacturer: Viridian Therapeutics
Type: Full IGF-1R antagonist monoclonal antibody
FDA approval: June 2026, under Priority Review, following Breakthrough Therapy Designation
How it works: Like Tepezza, Lumvoa blocks IGF-1R signaling, which is believed to reduce orbital inflammation and the tissue changes seen in TED.
How it’s given: IV infusion — 5 total infusions, administered once every 3 weeks (about 12 weeks of treatment). The first infusion takes about 45 minutes; later ones take about 30 minutes. Infusions can be done in a medical office or through a home infusion provider.
What makes it notable: Lumvoa is the first TED treatment approved with labeling that includes data for both active and chronic disease, based on two large phase 3 trials (THRIVE and THRIVE-2). It also showed strong results for complete resolution of diplopia.
Common side effects:
| Tepezza | Lumvoa | |
|---|---|---|
| Generic name | teprotumumab-trbw | veligrotug-vvze |
| FDA approval | 2020 (active); 2023 (chronic added) | 2026 (active and chronic, from initial approval) |
| Mechanism | IGF-1R inhibitor | Full IGF-1R antagonist |
| Number of infusions | 8 | 5 |
| Treatment duration | ~21 weeks | ~12 weeks |
| Approved for chronic TED | Yes (since 2023) | Yes (from approval) |
Note: There are no published head-to-head clinical trials directly comparing Tepezza and Lumvoa, so this comparison reflects each drug’s individual trial data and approved labeling, not a controlled comparison between them.
No. Graves’ disease is an autoimmune condition affecting the thyroid gland. TED is a related but separate autoimmune condition affecting the eyes, and it can occur in people with or without active thyroid dysfunction.
Mild cases may improve as the active inflammatory phase resolves. However, physical changes like bulging eyes or double vision often don’t fully reverse without treatment.
No. Both are treatments that target the underlying disease activity and have been shown to reduce specific symptoms like proptosis and diplopia, but neither is described as a cure.
Candidacy depends on disease severity, activity, duration, and individual health history. This is a decision made with an ophthalmologist, oculoplastic surgeon, or endocrinologist.
Yes — both carry risks including hearing problems and elevated blood sugar, among other side effects. A full risk discussion with a prescribing physician is essential before starting treatment.
If you’re experiencing symptoms of Thyroid Eye Disease (TED), our team is here to help. Call us today to schedule a TED consultation and learn more about available treatment options, including Tepezza and Lumvoa infusions.
