Lanadelumab is effective in patients with severe hereditary angioedema (HAE), according to the first national UK audit of the treatment.
“This real-world data demonstrates that lanadelumab is effective in patients with severe HAE, despite prior prophylaxis, including those previously on prophylactic C1-inhibitor, and possibly with greater control,” the study authors said.
Treatment with lanadelumab reduced total and severe monthly attacks at all time points when compared to the number at baseline. At 6 months, the reductions in total and severe monthly attacks were 87.7% and 92.2%, respectively. These proportions increased to 93.5% and 94.1%, respectively, at 12 months. Results were similar for patients who had received prior C1-inhibitor prophylaxis.
Moreover, treatment with lanadelumab allowed for a reduction in the proportion of severe attacks at 1 and 6 months. The proportion of attacks requiring C1-inhibitor decreased by 85.7% and 97.2% at 6 and 12 months, respectively, whereas those requiring icatibant decreased by 94.7% and 93.7%, respectively. The number of acute attacks requiring 2 doses of C1-inhibitor was reduced by 95.2% at 6 months and 100% at 12 months.
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On the other hand, 5.6% and 9.09% of patients failed to show a reduction of 50% or more in total attacks at 3 and 6 months, respectively. Only 1 patient failed to show a reduction of 50% or more in severe attacks.
Half of the 60 patients with data reduced their lanadelumab dosing frequency to 3 times per week or less, suggesting that dosing can be reduced without compromising treatment efficacy. Two patients returned to C1-inhibitor prophylaxis, and only 1 adverse event (injection site pain) was reported.
The study included data from 62 patients (mean age, 40.6±16.4 years; 72.6% female) from 16 centers. Most (98.4%) had type 1 HAE, and 90.3% had received prophylactic treatment prior to lanadelumab, predominantly C1-inhibitor concentrate (57.1% of those on prophylaxis), with 1 to 6 months of follow-up at baseline.
Dorr AD, Chopra C, Coulter TI, et al. Lanadelumab for the prevention of hereditary angioedema attacks: a real-world UK audit. Allergy. Published online December 12, 2022. doi:10.1111/all.15620