Patients with hereditary angiooedema experience resolution of acute attacks when they are treated with pasteurised C1-inhibitor concentrate (Berinert P), researchers reported here at the 2007 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting.
The retrospective study showed that the angiooedema episodes resolved an average of 1.3 hours after treatment. Because there is no approved pharmaceutical treatment indicated specifically for hereditary angiooedema in the United States, the findings are encouraging and have motivated the investigators to go forward and launch a prospective clinical trial of C1-inhibitor concentrate for this indication. C1-inhibitor concentrate has been used for this indication for several years in Europe.”Replacement therapy with C1-inhibitor concentrate can significantly reduce the duration and extent of symptoms in patients [with this condition] who experience oedema during acute attacks,” said senior investigator Konrad Bork, MD, professor, department of dermatology, University of Mainz, Mainz, Germany. “The study adds to the growing body of research demonstrating the safety and efficacy of C1-inhibitor concentrate in reducing these attacks.”Hereditary angiooedema is caused by C1-inhibitor deficiency, Dr. Bork said in his poster presentation February 27th.Dr. Bork and coinvestigator Petra Staubach reviewed the charts of 43 patients with hereditary angiooedema who had 1,828 acute episodes between 1976 and 2005. In 1,445 attacks, patients were treated with 500 units of C1-inhibitor concentrate. In 383 attacks, they were treated with 1,000 units. Following each treatment, patients responded to standardised questionnaires used in personal interviews. The responses for the treated attacks were compared with 6,625 untreated episodes in the same patients.The 1,828 treated episodes affected the face in 440 attacks, the hands and arms in 721 attacks, the feet and legs in 516 attacks, the genitals in 122 attacks, and the trunk in 29 attacks. Symptoms were relieved in an average of 1.3 hours in the treated attacks and after 60 hours in the untreated attacks. Length of attacks was decreased from 88 hours in the untreated attacks to 40.8 hours in the treated attacks.The investigators noted that all patients responded to treatment with C1-inhibitor concentrate. However, in 24 attacks among 4 patients the course of the treated attacks remained the same as in untreated attacks, although symptoms were milder.The researchers noted that the treatment was more effective when it was injected early in the attacks compared with later on. No drug-related adverse effects were documented.(Source: American Academy of Allergy, Asthma, and Immunology (AAAAI) Annual Meeting : University of Mainz : April 2007.)