From Clinical Research, AllerVie Health, Birmingham, Alabama.
Allergy/Immunology, Asthma and Allergy Associates, Colorado Springs, Colorado.
Allergy Asthma Proc. 2024 Jul 1;45(4):247-254. doi: 10.2500/aap.2024.45.240021.
Hereditary angioedema (HAE) is a rare genetic condition characterized by painful and often debilitating swelling attacks. Little is known about the differences in outcomes between patients with HAE types I or II (type I: HAE caused by C1 esterase inhibitor deficiency; type II: HAE caused by C1 esterase inhibitor dysfunction), with decreased or dysfunctional C1 esterase inhibitor (C1-INH), and those with normal C1-INH (nC1-INH-HAE). To compare physician- and patient-reported real-world outcomes in patients with HAE types I/II versus patients with nC1-INH-HAE. Data were drawn from the Adelphi HAE Disease Specific Programme a real-world, cross-sectional survey of HAE-treating physicians and their patients in the United States conducted between July and November 2021. Physicians reported patient disease activity and severity, and recent attack history. Patient-reported outcomes were collected. Bivariate tests used were either the Student's -test, the Fisher exact test, or Mann-Whitney U test. Physicians (N = 67) provided data on 368 patients (92.4% HAE types I/II and 7.6% nC1-INH-HAE). Physicians reported that a higher proportion of patients with nC1-INH-HAE had moderate or high disease activity and moderate or severe disease severity both at diagnosis and at data collection versus those with HAE types I/II. Patients with nC1-INH-HAE versus patients with HAE types I/II experienced increased attack severity (34.6% versus 4.4%) and hospitalization rate during the most recent attack (39.3% versus 6.6%), and reported lower health status and quality of life, the European Quality of Life 5 Dimension 5 Level (US tariff) and Angioedema Quality of Life, respectively. On average, 25% of the patients with nC1-INH-HAE reported absenteeism and work or activity impairment due to HAE compared with 2.7% of patients with HAE types I/II. Both patient groups reported improvements in disease activity and severity from diagnosis to the time of data collection. These real-world findings suggest that patients with nC1-INH-HAE have increased disease activity and severity, and experience greater impairment to their quality of life, work, and daily functioning than patients with HAE types I/II. Powered statistical analyses are required to confirm these findings.
遗传性血管性水肿 (HAE) 是一种罕见的遗传性疾病,其特征是疼痛和经常使人虚弱的肿胀发作。人们对 HAE 一型或二型 (一型:由 C1 酯酶抑制剂缺乏引起;二型:由 C1 酯酶抑制剂功能障碍引起)、C1 酯酶抑制剂减少或功能障碍 (C1-INH) 和 C1-INH 正常 (nC1-INH-HAE) 的患者之间的结局差异知之甚少。本研究旨在比较 HAE 一型/二型患者与 nC1-INH-HAE 患者的医生和患者报告的真实世界结局。研究数据来自 Adelphi HAE 疾病专项计划,这是一项于 2021 年 7 月至 11 月在美国进行的针对 HAE 治疗医生及其患者的真实世界、横断面调查。医生报告了患者的疾病活动度和严重程度,以及最近的发作史。收集了患者报告的结局。使用的双变量检验方法是学生 t 检验、Fisher 确切检验或 Mann-Whitney U 检验。医生 (N = 67) 提供了 368 名患者的数据 (92.4% HAE 一型/二型和 7.6% nC1-INH-HAE)。医生报告称,与 HAE 一型/二型患者相比,更多的 nC1-INH-HAE 患者在诊断时和数据收集时具有较高的疾病活动度和中重度疾病严重程度。与 HAE 一型/二型患者相比,nC1-INH-HAE 患者的发作严重程度更高 (34.6% 比 4.4%),最近一次发作时的住院率更高 (39.3% 比 6.6%),健康状况和生活质量分别报告更低,即欧洲五维健康量表 5 级 (美国关税) 和血管性水肿生活质量量表。平均而言,25%的 nC1-INH-HAE 患者因 HAE 而缺勤和工作或活动能力受损,而 HAE 一型/二型患者的这一比例为 2.7%。两组患者均报告自诊断以来疾病活动度和严重程度有所改善。这些真实世界的发现表明,与 HAE 一型/二型患者相比,nC1-INH-HAE 患者的疾病活动度和严重程度更高,对生活质量、工作和日常功能的影响更大。需要进行有统计学意义的分析来证实这些发现。