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重组人C1抑制剂治疗急性血管性水肿发作

Recombinant human C1-inhibitor in the treatment of acute angioedema attacks.

作者信息

Choi Goda, Soeters Maarten R, Farkas Henriette, Varga Lilian, Obtulowicz Krystyna, Bilo Barbara, Porebski Greg, Hack C Erik, Verdonk René, Nuijens Jan, Levi Marcel

机构信息

Department of Internal Medicine, Academic Medical Center, Free University Medical Center, Amsterdam, The Netherlands.

出版信息

Transfusion. 2007 Jun;47(6):1028-32. doi: 10.1111/j.1537-2995.2007.01239.x.

Abstract

BACKGROUND

Patients with hereditary C1-inhibitor deficiency have recurrent attacks of angioedema, preferably treated with C1-inhibitor concentrate. A recombinant human C1-inhibitor (rHuC1INH) was developed, derived from milk from transgenic rabbits. This study was undertaken to investigate the effects of rHuC1INH in the treatment of acute angioedema attacks in patients with a hereditary C1-inhibitor deficiency.

STUDY DESIGN AND METHODS

Patients with hereditary C1-inhibitor deficiency were treated with rHuC1INH (at a dose of 100 U/kg) within 8 hours after onset of an acute attack. Time to initiation of relief and time to minimal symptoms were reported by both the patient and the treating physician.

RESULTS

Thirteen severe angioedema attacks in 9 patients with hereditary C1-inhibitor deficiency were treated with rHuC1INH. There was rapid improvement of clinical conditions for all attacks, with approximately 80 percent of treated patients experiencing symptom relief within 2 hours and minimal symptoms within 12 hours. There were no drug-related adverse events or immunogenic reactions to C1-inhibitor or rabbit proteins.

CONCLUSION

The transgenically produced rHuC1INH was successfully used in the treatment of acute angioedema attacks in patients with hereditary C1-inhibitor deficiency.

摘要

背景

遗传性C1抑制物缺乏症患者会反复发生血管性水肿,最好用C1抑制物浓缩剂进行治疗。一种重组人C1抑制物(rHuC1INH)已研发出来,它源自转基因兔的乳汁。本研究旨在调查rHuC1INH对遗传性C1抑制物缺乏症患者急性血管性水肿发作的治疗效果。

研究设计与方法

遗传性C1抑制物缺乏症患者在急性发作开始后的8小时内接受rHuC1INH治疗(剂量为100 U/kg)。患者和主治医生均报告了开始缓解的时间和出现最小症状的时间。

结果

9例遗传性C1抑制物缺乏症患者的13次严重血管性水肿发作接受了rHuC1INH治疗。所有发作的临床状况均迅速改善,约80%的接受治疗患者在2小时内症状缓解,12小时内出现最小症状。没有与药物相关的不良事件,也没有对C1抑制物或兔蛋白的免疫反应。

结论

转基因生产的rHuC1INH成功用于治疗遗传性C1抑制物缺乏症患者的急性血管性水肿发作。

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