Table 1

Novel and potential immunotherapies in clinical and preclinical trials for TO

Class of drugsMechanism of actionExample
CD20 monoclonal antibodyDeplete B cells and precursor by recognising surface CD20 markerRituximab110–112
IL-6 receptor monoclonal antibodyBinding to soluble and membrane bound IL-6 receptor and inhibit pro-inflammatory cytokine IL-6Tocilizumab57
TNF-α monoclonal antibodyBind and block TNF-α from interacting with cell surface TNF receptors.Adalimumab118
Soluble TNF receptorA soluble TNF-α receptor-Fc protein that prevent TNF-α and TNF-β from binding to membrane bound TNF receptorsEtanercept116
Small-molecule TSHR antagonistBinding within transmembrane region of TSHR, blocking signalling of TSH either as allosteric inverse agonist or neutral antagonistOrg 274179-0113
IGF-1R monoclonal antibodyIGF-1R blocking, reduces both IGF-1R and TSHR expressionTeprotumumab115
AntioxidantIncrease reserve for selenoproteins involve in oxidation reduction activity, eg, glutathione peroxidase, thioredoxin reductase, iodothyronine deiodinasesSodium selenite121
  • IGF-1R, insulin-like growth factor-1 receptor; IL, interleukin; TNF, tumour necrosis factor; TO, thyroid orbitopathy; TSHR, thyrotropin receptor.