Name of the Procedure:

Injection, teprotumumab-trbw, 10 mg
Common Names: Teprotumumab Injection
Technical/Medical Terms: Teprotumumab-trbw, HCPCS J3241

Summary

Teprotumumab injection is a specialized intravenous treatment used to manage certain eye-related conditions. Specifically, it targets and treats thyroid eye disease (TED), an inflammatory disorder affecting the muscles and tissues around the eyes.

Purpose

Medical Conditions Addressed:

• Thyroid Eye Disease (TED)

  Goals/Expected Outcomes:

• Reduction of eye bulging (proptosis)
• Alleviation of inflammation and swelling
• Improvement of vision and reduction of double vision

Indications

Specific Symptoms/Conditions:

• Eye bulging and swelling caused by thyroid eye disease
• Double vision
• Pain or discomfort around the eyes

Patient Criteria:

• Diagnosed with active thyroid eye disease
• Adequate general health to undergo infusion therapy

Preparation

Pre-Procedure Instructions:

• Patients may need to fast for a few hours before the injection
• Adjust current medications under medical advice

Pre-Diagnostic Tests or Assessments:

• Blood tests to check thyroid function
• Imaging studies like CT or MRI to assess eye anatomy

Procedure Description

1. Patient Setup: The patient is comfortably seated or lying down.
2. Venous Access: A healthcare professional inserts an IV line, usually in the arm.
3. Infusion: Teprotumumab is infused through the IV over a specified period.
4. Monitoring: The patient is monitored for any adverse reactions during and after the infusion.

Tools/Equipment Used:

• IV drip setup
• Teprotumumab medication
• Monitoring equipment for vital signs

Anesthesia/Sedation:

• None required; local discomfort may be managed with topical anesthetic

Duration

The infusion process typically takes about 60 to 90 minutes per session. Multiple sessions may be required.

Setting

The procedure is usually performed in an outpatient infusion center or a hospital's day treatment unit.

Personnel

• Infusion nurse or specialist
• Supervising physician
• On-site staff to monitor patient’s vital signs

Risks and Complications

Common Risks:

• Mild to moderate injection site reactions
• Headache
• Muscle spasms

Rare Risks:

• Allergic reactions
• Hyperglycemia (high blood sugar levels)
• Hearing problems

Possible Complications and Management:

• Immediate medical attention for allergic reactions
• Monitoring and managing blood sugar levels

Benefits

Expected Benefits:

• Improvement in eye appearance and function
• Relief from pain and discomfort
• Enhanced quality of life

Timeframe for Benefits:

• Benefits can often be noticed after a few treatment sessions

Recovery

Post-Procedure Care:

• Regular monitoring for adverse reactions
• Maintain hydration and adhere to any dietary or activity restrictions advised by the healthcare provider

Expected Recovery Time:

• Minimal downtime, usual activities can often be resumed quickly

Restrictions/Follow-Up:

• Follow-up visits for additional infusions and monitoring
• Regular eye examinations

Alternatives

Other Treatment Options:

• Oral corticosteroids
• Orbital radiotherapy

• Surgical intervention (orbital decompression surgery)

  Pros and Cons of Alternatives:

• Corticosteroids: Quick relief but potential for systemic side effects
• Radiotherapy: Non-invasive but variable effectiveness
• Surgery: Effective for severe cases but invasive and with longer recovery

Patient Experience

During the Procedure:

• Mild discomfort at IV site
• Possible nausea or headache during infusion

After the Procedure:

• Mild fatigue
• Monitoring for any delayed side effects

Pain Management and Comfort Measures:

• Topical anesthetics for IV site
• Medications to manage side effects like nausea or headaches as needed

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