EPIDEMIOLOGY AND TREATMENT PATTERNS OF THRYOID EYE DISEASE IN SPAIN: POPULATION-BASED REAL-WORLD EVIDENCE
Author(s)
Constanza Barrancos, MD, MSc1, Vartika Savarna, MPP2, Scarlette Kienzle, MPH, MSc2, Ignasi Campos Tapias, BSc3, Berta Jover Llorens, BSc3, Ignacio Hernández, BSc4, Christina Giannopoulou, MSc5, Alexandra Eddy, MSc6.
1Hospital Ramón y Cajal, Madrid, Spain, 2Cytel, Berlin, Germany, 3Amgen (Europe) GmbH, Barcelona, Spain, 4Atrys Health, Madrid, Spain, 5Amgen (Europe) GmbH, Rotkreuz, Switzerland, 6Amgen, Raleigh, NC, USA.
1Hospital Ramón y Cajal, Madrid, Spain, 2Cytel, Berlin, Germany, 3Amgen (Europe) GmbH, Barcelona, Spain, 4Atrys Health, Madrid, Spain, 5Amgen (Europe) GmbH, Rotkreuz, Switzerland, 6Amgen, Raleigh, NC, USA.
OBJECTIVES: Thyroid eye disease (TED) is a progressive autoimmune condition posing substantial clinical burden, particularly in moderate-to-severe cases. This study describes prevalence/incidence of TED and real-world treatment patterns in Spain.
METHODS: This retrospective observational study used the Spanish BIG-PAC electronic medical records database. Adults with a confirmed TED-related ocular manifestation and thyrotoxicosis within 12 months were included. Active (clinical activity score [CAS]≥3) and chronic (CAS<3, and ≥1 surgery without dysthyroid/compressive optic neuropathy or proptosis, diplopia or orbital inflammation diagnosis) moderate-to-severe TED patients were identified. For 2013-2023, annual prevalence and incidence (per 100,000 patients/person-years [PY]) were estimated. Treatment patterns were assessed for active and chronic moderate-to-severe cases over 2013-2024 to ensure minimum 12-month follow-up.
RESULTS: From 2013-2023, 4,781 patients with TED were identified (mean age 58; 64% women). Prevalence ranged between 98-112 per 100,000; active moderate-to-severe and chronic moderate-to-severe disease ranged between 17-18 and 22-26 per 100,000 respectively. Prevalence was higher in females than males (168 vs 51 per 100,000 in 2023) and increased among those ≤50 years, particularly in ages 30-39 (46-86 per 100,000). Incidence was ~9 per 100,000 PY, with 1-2 per 100,000 PY for active and chronic moderate-to-severe cases. Among incident moderate-to-severe cases (active N=185; chronic N=241), active disease was primarily treated with intravenous corticosteroid monotherapy (64%), orbital radiotherapy (27%), biologics (23%), and immunosuppressant-steroid combinations (23%). Chronic disease was managed predominantly with surgery (orbital decompression (27%), eyelid surgery (21%), and extraocular muscle procedures (12%)).
CONCLUSIONS: TED epidemiology in Spain remained stable, with higher prevalence in women and considerable impact in working-age adults. Treatment patterns highlight reliance on intensive off-label pharmacologic treatments or invasive approaches, suggesting an unmet need for disease-targeting, approved treatment options for moderate-to-severe TED.
METHODS: This retrospective observational study used the Spanish BIG-PAC electronic medical records database. Adults with a confirmed TED-related ocular manifestation and thyrotoxicosis within 12 months were included. Active (clinical activity score [CAS]≥3) and chronic (CAS<3, and ≥1 surgery without dysthyroid/compressive optic neuropathy or proptosis, diplopia or orbital inflammation diagnosis) moderate-to-severe TED patients were identified. For 2013-2023, annual prevalence and incidence (per 100,000 patients/person-years [PY]) were estimated. Treatment patterns were assessed for active and chronic moderate-to-severe cases over 2013-2024 to ensure minimum 12-month follow-up.
RESULTS: From 2013-2023, 4,781 patients with TED were identified (mean age 58; 64% women). Prevalence ranged between 98-112 per 100,000; active moderate-to-severe and chronic moderate-to-severe disease ranged between 17-18 and 22-26 per 100,000 respectively. Prevalence was higher in females than males (168 vs 51 per 100,000 in 2023) and increased among those ≤50 years, particularly in ages 30-39 (46-86 per 100,000). Incidence was ~9 per 100,000 PY, with 1-2 per 100,000 PY for active and chronic moderate-to-severe cases. Among incident moderate-to-severe cases (active N=185; chronic N=241), active disease was primarily treated with intravenous corticosteroid monotherapy (64%), orbital radiotherapy (27%), biologics (23%), and immunosuppressant-steroid combinations (23%). Chronic disease was managed predominantly with surgery (orbital decompression (27%), eyelid surgery (21%), and extraocular muscle procedures (12%)).
CONCLUSIONS: TED epidemiology in Spain remained stable, with higher prevalence in women and considerable impact in working-age adults. Treatment patterns highlight reliance on intensive off-label pharmacologic treatments or invasive approaches, suggesting an unmet need for disease-targeting, approved treatment options for moderate-to-severe TED.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH117
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)