Name of the Procedure:

Injection of teprotumumab-trbw, commonly known as Tepezza®.

Summary

The injection of teprotumumab-trbw involves administering a medication called Tepezza®, which is used for treating thyroid eye disease (TED).

Purpose

Teprotumumab-trbw is used to address thyroid eye disease, an autoimmune condition associated with thyroid dysfunction that leads to inflammation, swelling, and damage to the tissues around the eyes. The goal of the injection is to reduce these symptoms, improve the appearance of the eyes, and enhance the patient's quality of life.

Indications

• Moderate to severe thyroid eye disease
• Proptosis (bulging of the eyes)
• Inflammation of the eye tissues
• Symptoms like pain, redness, and double vision
• Progressive deterioration of eye function

Preparation

• No specific fasting or strict preparation needed.
• The healthcare provider will review the patient's medical history.
• Pre-treatment assessments might include blood tests and eye examinations.

Procedure Description

1. Patient's medical history and allergies are reviewed.
2. The site of injection is cleaned and sterilized.
3. Teprotumumab-trbw is administered intravenously.
4. The process involves several small injections over a recommended treatment cycle, typically once every three weeks for a total of 8 infusions.

5. The patient may be monitored for a short period post-injection to manage any immediate reactions.

   Duration

   Each infusion session typically lasts 60-90 minutes.

Setting

The procedure is performed in an outpatient setting such as a hospital infusion center or clinic.

Personnel

• Infusion nurses
• Physicians specialized in endocrinology or ophthalmology
• Medical assistants

Risks and Complications

• Common risks: infusion reactions, muscle spasm, nausea, alopecia, fatigue.
• Rare risks: severe allergic reactions, difficulty breathing, cardiac complications.

Management involves prompt identification and treatment of symptoms, which could include medications to counteract reactions.

Benefits

• Reduction in inflammation and eye bulging
• Improvement in vision and reduction of double vision
• Enhanced appearance of the eyes
• Relatively rapid onset of benefits, often noticeable after the first few infusions

Recovery

• Post-injection care involves monitoring for adverse reactions.
• Patients can typically resume their normal activities shortly after each session.
• Follow-up appointments to assess progress and decide on continued treatment.

Alternatives

• Oral or intravenous corticosteroids: Can reduce inflammation but have more side effects.
• Orbital decompression surgery: More invasive, used for severe cases.
• Radiation therapy: Less commonly used, with varying results.

Each alternative should be weighed against the efficacy, invasiveness, side effects, and patient's overall health condition before making a decision.

Patient Experience

• During the procedure: Some discomfort from the IV, possible mild side effects like headaches or muscle spasms.
• After the procedure: Generally minimal downtime, with careful monitoring of side effects.
• Pain management might include over-the-counter pain relievers if necessary.
• Comfort measures: Patients are encouraged to stay hydrated and report any severe symptoms immediately to their healthcare provider.

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