Maurer Marcus, Cimbollek Stefan, Kelly Maebh, Rodney Kyle, Elliott John, LoboGuerrero Eduardo, Magerl Markus
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.
Front Immunol. 2025 May 14;16:1576235. doi: 10.3389/fimmu.2025.1576235. eCollection 2025.
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.
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。