As a novel biologic agent targeting the IGF-1 receptor, Lumvoa may cause multisystem adverse reactions while treating thyroid eye disease.

I. Common Systemic Reactions

1. Musculoskeletal System

(1) Muscle spasms are the most frequently reported reaction, which may present as local or widespread involuntary contraction of muscle groups.

(2) Most are mild to moderate in severity and usually do not affect daily life.

(3) During treatment, adequate fluid and electrolyte intake should be supplemented, and strenuous exercise that may provoke exacerbation should be avoided.

2. Gastrointestinal Symptoms

(1) Nausea and diarrhea are relatively common, mostly occurring within a few days after dosing.

(2) A bland diet with small, frequent meals is recommended, avoiding greasy and irritating foods.

(3) If diarrhea persists or is accompanied by abdominal pain or bloody stools, the possibility of inflammatory bowel disease should be alerted.

3. Fatigue and Malaise

(1) Some patients experience marked tiredness and decreased exercise tolerance.

(2) It is advisable to arrange adequate rest and avoid prolonged work or physical exertion.

(3) If fatigue progresses progressively, the physician should be informed to evaluate for anemia or other underlying factors.

4. Skin and Mucosal Changes

(1) Dry skin and desquamation may occur.

(2) During treatment, moisturizing care should be taken with mild emollient products.

(3) During follow-up, hair loss and brittle nails may appear; although they do not affect vital signs, psychological counseling for patients is needed.

II. Adverse Reactions Related to Specific Organs

1. Hearing Impairment (High Attention Required)

(1) May present as tinnitus, aural fullness, or hearing loss; in severe cases, irreversible damage may occur.

(2) Objective examinations such as pure-tone audiometry should be performed regularly before, during, and after treatment.

(3) If abnormal ear sounds, blurred hearing, or balance disturbances occur, an otology consultation should be sought immediately.

2. Abnormal Glucose Metabolism

(1) The drug may cause elevated blood glucose, especially in patients with diabetes or impaired glucose tolerance.

(2) Fasting and postprandial blood glucose should be monitored regularly before and after treatment.

(3) Diabetic patients should collaborate with endocrinology to adjust hypoglycemic regimens in a timely manner; non-diabetic patients who develop polydipsia, polyuria, or weight loss should be evaluated for new-onset hyperglycemia.

3. Aural Discomfort Symptoms

(1) In addition to hearing changes, some patients experience a sensation of pressure, blockage, or "fullness" in the ear.

(2) These symptoms may occur alone or along with hearing abnormalities and should be reported promptly to the physician, with otologic examination to clarify the nature.

III. Infusion-Related and Delayed Reactions

1. Infusion Reactions

(1) Transient blood pressure elevation, chills, fever, and headache may occur during or shortly after infusion. Most reactions are mild to moderate and can be alleviated by slowing the infusion rate or administering antipyretics/analgesics and antihistamines.

(2) The first infusion should be performed under monitoring conditions; subsequent infusions can be adjusted in rate according to tolerability.

2. Inflammatory Bowel Disease (IBD) Risk

(1) May induce or exacerbate IBD, including in patients without prior history.

(2) If persistent or bloody diarrhea, abdominal pain, tenesmus, or fecal incontinence occur, the drug should be discontinued immediately and gastroenterology consultation sought.

(3) During treatment, any changes in bowel function should be actively reported to the physician.

3. Delayed Skin and Adnexal Changes

(1) Within a few months after treatment completion, some patients experience increased hair loss or brittle nails.

(2) Although self-limiting, patients should be informed in advance to avoid excessive anxiety, and nutritional support with appropriate biotin, vitamin B complex, etc., is recommended.

4. Other Conditions Requiring Vigilance

(1) A small number of patients may develop thrombocytopenia, manifesting as ecchymosis, gingival bleeding, etc.

(2) If unexplained bleeding tendency is found, a complete blood count should be performed promptly, and further management should be discussed with the physician.