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西班牙和德国遗传性血管性水肿(HAE)患者皮下注射C1酯酶抑制剂(C1INH)长期预防的有效性和使用情况的真实世界证据。

Real-world evidence of the effectiveness and utilization of subcutaneous C1INH long-term prophylaxis in patients with HAE in Spain and Germany.

作者信息

Maurer Marcus, Cimbollek Stefan, Kelly Maebh, Rodney Kyle, Elliott John, LoboGuerrero Eduardo, Magerl Markus

机构信息

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Immunology and Allergology, Berlin, Germany.

出版信息

Front Immunol. 2025 May 14;16:1576235. doi: 10.3389/fimmu.2025.1576235. eCollection 2025.

Abstract

Hereditary angioedema (HAE) types 1/2 are rare genetic disorders leading to C1 inhibitor (C1INH) deficiency/dysfunction. Guidelines recommend long-term prophylaxis (LTP) to prevent HAE attacks. Subcutaneous (SC) C1INH replacement therapy is approved for LTP in patients with HAE (age indication varies between countries). There is little real-world data on the outcomes of patients who switch to C1INH SC in Europe, particularly those who switch from C1INH IV. This retrospective patient chart analysis captured real-world evidence of the effectiveness of C1INH SC LTP in patients with HAE in Germany (n=69) and Spain (n=37). The primary endpoint was change in annualized attack rate (AAR) in patients who used C1INH IV LTP during a 6-month baseline period and switched to C1INH SC LTP for ≥6 months. Switching to C1INH SC LTP from C1INH IV LTP was associated with a 73.2% reduction in AAR (n=48; P<0.001) compared to baseline. Emergency Room (ER) visits and rescue medication use were also significantly reduced after switching to C1INH SC LTP from C1INH IV LTP. A similar reduction in AAR (68.9%), ER visits (49.8%), and rescue medication use (61.9%) was observed in the overall population (n=105), regardless of treatment at baseline. Similar changes from baseline were seen in patients from Germany and Spain.

摘要

1/2型遗传性血管性水肿(HAE)是罕见的遗传性疾病,可导致C1抑制剂(C1INH)缺乏/功能障碍。指南建议进行长期预防(LTP)以防止HAE发作。皮下(SC)C1INH替代疗法已被批准用于HAE患者的LTP(不同国家的年龄适应症有所不同)。在欧洲,关于改用C1INH SC的患者的治疗结果,尤其是那些从静脉注射C1INH转换而来的患者,实际数据很少。这项回顾性患者病历分析收集了德国(n = 69)和西班牙(n = 37)HAE患者中C1INH SC LTP有效性的真实世界证据。主要终点是在6个月的基线期使用静脉注射C1INH LTP并改用C1INH SC LTP≥6个月的患者的年化发作率(AAR)变化。与基线相比,从静脉注射C1INH LTP改用C1INH SC LTP可使AAR降低73.2%(n = 48;P < 0.001)。从静脉注射C1INH LTP改用C1INH SC LTP后,急诊室(ER)就诊和急救药物的使用也显著减少。在总体人群(n = 105)中,无论基线治疗如何,AAR(68.9%)、ER就诊(49.8%)和急救药物使用(61.9%)均有类似程度的降低。德国和西班牙的患者与基线相比有类似的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20b8/12116583/2c22d0bc29ce/fimmu-16-1576235-g001.jpg

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