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Caballero T, Alonso C, Baeza ML, Baynova K, Cabeza J, Cortés I, Escobar Oblitas D, Guilarte M, Joral A, Jurado Palomo J, Lara Jiménez MÁ, Martínez Virto A, Medrano L, Monte Boquet E, Navarro M, Pérez D, Plá Martí MJ, Smith Foltz SL, Suero C, Zamora C. Hereditary angioedema in Spain: medical care and patient journey. Orphanet J Rare Dis 2024; 19:210. [PMID: 38773490 PMCID: PMC11110377 DOI: 10.1186/s13023-024-03182-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 04/01/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1INH) is a genetic rare disease characterized by recurrent, transient and unpredictable episodes of cold, non-pruriginous oedema without associated urticaria. The characteristics of the disease have a considerable impact on the quality of life of patients. The aim of this study was to increase understanding of the patient journey of HAE in Spain. METHODS A multidisciplinary committee of 16 HAE experts (allergy, immunology, emergency department, hospital pharmacy and nursing) and 3 representatives of the Spanish Hereditary Angioedema Patient Association (AEDAF) who were patients or caregivers participated in the study. A review of the publications on HAE treatment was performed. Semi-structured interviews were performed to HAE experts, patients, or caregivers. Three meetings with the experts, patients and caregivers were held to share, discuss, and validate data obtained from literature and interviews and to build the model. RESULTS Throughout the project, the patient journey has been drawn up, dividing it into the stages of pre-diagnosis, diagnosis and treatment/follow-up. Some areas for improvement have been identified. Firstly, there is a need to enhance awareness and training on HAE among healthcare professionals, with a particular emphasis on primary care and emergency department personnel. Secondly, efforts should be made to minimize patient referral times to allergy/immunology specialists, ensuring timely access to appropriate care. Thirdly, it is crucial to encourage the study of the relatives of diagnosed patients to early identify potential cases. Fourthly, equitable access to self-administered treatments should be ensured, facilitated by systems that enable medication delivery at home and proper education and training for patients. Equitable access to long-term prophylactic treatment should also be prioritized for all patients in need. To standardize HAE management, the development of consensus guidelines that reduce variability in clinical practice is essential. Lastly, promoting research studies to enhance knowledge of the disease and align its treatment with new developments in the healthcare field should be encouraged. CONCLUSIONS The knowledge of the patient journey in HAE allowed us to identify improvement areas with the final aim to optimize the disease management.
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Affiliation(s)
- Teresa Caballero
- Allergy department, Hospital Universitario La Paz, Madrid, Spain.
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
- Biomedical Research Network on Rare Diseases (CIBERER U754), Madrid, Spain.
| | - Carmen Alonso
- Nursing department, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - María Luisa Baeza
- Allergy department, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
- Biomedical Research Network on Rare Diseases U761 (CIBERER), Madrid, Spain
| | - Krasimira Baynova
- Allergy department, Hospital Universitario Virgen del Rocío, Madrid, Spain
| | - José Cabeza
- Hospital Pharmacy, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Danilo Escobar Oblitas
- Immunology department, Hospital Universitario Son Espases, Palma de Mallorca, Illes Balears, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Illes Balears, Spain
| | - Mar Guilarte
- Allergy department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Alejandro Joral
- Allergy department, Hospital Universitario Donostia, Gipuzkoa, Spain
| | - Jesús Jurado Palomo
- Allergy department, Hospital General Universitario Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain
| | | | | | - Laura Medrano
- Asociación Española De Angioedema Familiar, Torrelodones, Madrid, Spain
| | - Emilio Monte Boquet
- Hospital Pharmacy, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Montserrat Navarro
- Hospital Pharmacy, Hospital Universitario Santa María, Lleida, 25198, Spain
| | - Diego Pérez
- Nursing department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | - Coral Suero
- Emergency department, Hospital Regional Universitario de Málaga, Málaga, 29010, Spain
| | - Carolina Zamora
- Asociación Española De Angioedema Familiar, Torrelodones, Madrid, Spain
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2
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Cherrez-Ojeda I, Bousquet J, Giménez-Arnau A, Godse K, Krasowska D, Bartosińska J, Szczepanik-Kułak P, Wawrzycki B, Kolkhir P, Allenova A, Allenov A, Tkachenko S, Mitrevska NT, Mijakoski D, Stoleski S, Kolacinska-Flont M, Kuprys-Lipinska I, Molinska J, Kasperska-Zając A, Zajac M, Zamłyński M, Mihaltan F, Ulmeanu R, Zalewska-Janowska A, Tomaszewska K, Al-Ahmad M, Al-Nesf MA, Ibrahim T, Aqel S, Pesqué D, Rodríguez-González M, Wakida-Kuzunoki GH, Ramon GD, Ramon GN, Neisinger S, Bonnekoh H, Rukhadze M, Khoshkhui M, Fomina D, Larenas-Linnemann D, Košnik M, Kara RO, Caballero López CG, Liu Q, Ivancevich JC, Ensina LF, Rosario N, Kvedariene V, Ben-Shoshan M, Jardim Criado RF, Bauer A, Cherrez A, Cherrez S, Chong-Neto H, Rojo-Gutierrez MI, Rudenko M, Larco Sousa JI, Lesiak A, Matos E, Tinoco I, Shijin CC, Logroño RH, Sagñay JC, Faytong-Haro M, Robles-Velasco K, Zuberbier T, Maurer M. Usage prevalence of angioedema patient-reported outcome measures: Results from the UCARE and ACARE PROMUSE study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00464-1. [PMID: 38734372 DOI: 10.1016/j.jaip.2024.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador; RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador.
| | - Jean Bousquet
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
| | - Ana Giménez-Arnau
- Dermatology Department, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - Kiran Godse
- Department of Dermatology, D. Y. Patil University School of Medicine, Navi Mumbai, India
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Joanna Bartosińska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland; Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, Lublin, Poland
| | - Paulina Szczepanik-Kułak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Bartlomiej Wawrzycki
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Pavel Kolkhir
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
| | - Anastasiia Allenova
- Laboratory of Immune-Mediated Skin Diseases, Institute of Regenerative Medicine, Biomedical Science & Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Andrey Allenov
- Institute for Leadership and Health Management, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; State Budgetary Healthcare Institution of the City of Moscow, "City Polyclinic No. 2 10 of the Department of Health of the City of Moscow," Moscow, Russian Federation; Federal State Budgetary Scientific Institution, "N. A. Semashko National Research Institute of Public Health," Moscow, Russian Federation
| | - Sergey Tkachenko
- Russian Medical Academy of Сontinuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Natasa Teovska Mitrevska
- Dermatology Department, Remedika General Hospital, Skopje, Republic of North Macedonia; International Balkan University (IBU), Skopje, Republic of North Macedonia
| | - Dragan Mijakoski
- Institute of Occupational Health of RNM-Skopje, Skopje, Republic of North Macedonia; Faculty of Medicine, Ss. Cyril and Methodius, University of Skopje, Skopje, Republic of North Macedonia
| | - Sasho Stoleski
- Institute of Occupational Health of RNM-Skopje, Skopje, Republic of North Macedonia; Faculty of Medicine, Ss. Cyril and Methodius, University of Skopje, Skopje, Republic of North Macedonia
| | - Marta Kolacinska-Flont
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Lodz, Poland
| | - Izabela Kuprys-Lipinska
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Lodz, Poland
| | - Joanna Molinska
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Lodz, Poland
| | - Alicja Kasperska-Zając
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE/ACARE Network) & Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | - Magdalena Zajac
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE/ACARE Network) & Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | - Mateusz Zamłyński
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE/ACARE Network) & Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | | | | | - Anna Zalewska-Janowska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland
| | - Katarzyna Tomaszewska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Maryam Ali Al-Nesf
- Allergy and Immunology Division, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Tayseer Ibrahim
- Allergy and Immunology Division, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Sami Aqel
- Allergy and Immunology Division, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - David Pesqué
- Department of Dermatology, Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - German D Ramon
- Instituto de Alergia e Inmunologia del Sur, GA2LEN UCARE/ADCARE/ACARE Center, Bahia Blanca, Argentina
| | - Gonzalo N Ramon
- Instituto de Alergia e Inmunologia del Sur, GA2LEN UCARE/ADCARE/ACARE Center, Bahia Blanca, Argentina
| | - Sophia Neisinger
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
| | - Hanna Bonnekoh
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maia Rukhadze
- Center Allergy & Immunology/Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Science (MUMS), Mashhad, Iran
| | - Daria Fomina
- Moscow Practical and Research Center of Allergy and Immunology, Clinical City Hospital, Moscow, Russian Federation; Moscow Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Astana Medical University, Moscow, Russian Federation
| | | | - Mitja Košnik
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia Medical Faculty, University of Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Slovenia
| | - Rabia Oztas Kara
- Department of Dermatology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | - Qiang Liu
- Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | | | - Lius Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo and CPAlpha Clinical Research Center, São Paulo, Brazil
| | - Nelson Rosario
- Urticaria Center of Reference and Excellence (UCARE), Federal University of Parana, Rua General Carneiro, Curitiba, Brazil
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Moshe Ben-Shoshan
- Division of Allergy, Immunology and Dermatology, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | | | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Annia Cherrez
- RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador; Department of Dermatology, Venerology, and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sofia Cherrez
- RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador; Gemeinschaftspraxis PD, Dr. Jung & Kollegen, Krämpferstr. Erfurt, Germany
| | - Herberto Chong-Neto
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | - Michael Rudenko
- London Allergy and Immunology Centre, London, United Kingdom
| | | | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
| | - Edgar Matos
- Instituto Nacional de Salud del Nino, Lima, Peru
| | | | - Carolina Crespo Shijin
- Universidad Espíritu Santo, Samborondón, Ecuador; RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador
| | - Romina Hinostroza Logroño
- Universidad Espíritu Santo, Samborondón, Ecuador; RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador
| | - Juan C Sagñay
- Universidad Espíritu Santo, Samborondón, Ecuador; RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador
| | - Marco Faytong-Haro
- RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador; Universidad Estatal de Milagro, Cdla. Universitaria "Dr. Romulo Minchala Murillo", Guayas, Milagro, Ecuador; Sociology and Demography Department, Pennsylvania State University, University Park, Pa; Ecuadorian Development Research Laboratory, Daule, Guayas, Ecuador
| | - Karla Robles-Velasco
- Universidad Espíritu Santo, Samborondón, Ecuador; RespiraLab Research Group, Department of Allergy, Immunology & Pulmonology, Guayaquil, Ecuador
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
| | - Marcus Maurer
- Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany.
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3
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Reshef A, Buttgereit T, Betschel SD, Caballero T, Farkas H, Grumach AS, Hide M, Jindal AK, Longhurst H, Peter J, Riedl MA, Zhi Y, Aberer W, Abuzakouk M, Al Farsi T, Al Sukaiti N, Al-Ahmad M, Altrichter S, Aygören-Pürsün E, Baeza ML, Bara NA, Bauer A, Bernstein JA, Boccon-Gibod I, Bonnekoh H, Bouillet L, Brzoza Z, Bygum A, Calderon O, de Albuquerque Campos R, Campos Romero FH, Cancian M, Chong-Neto HJ, Christoff G, Cimbollek S, Cohn DM, Craig T, Danilycheva I, Darlenski R, Du-Thanh A, Ensina LF, Fomina D, Fonacier L, Fukunaga A, Gelincik A, Giavina-Bianchi P, Godse K, Gompels M, Goncalo M, Gotua M, Guidos-Fogelbach G, Guilarte M, Kasperska-Zajac A, Katelaris CH, Kinaciyan T, Kolkhir P, Kulthanan K, Kurowski M, Latysheva E, Lauerma A, Launay D, Lleonart R, Lumry W, Malbran A, Ali RM, Nasr I, Nieto-Martinez S, Parisi C, Pawankar R, Piñero-Saavedra M, Popov TA, Porebski G, Prieto Garcia A, Pyatilova P, Rudenko M, Sekerel BE, Serpa FS, Sheikh F, Siebenhaar F, Soria A, Staevska M, Staubach P, Stobiecki M, Thomsen SF, Triggiani M, Valerieva A, Valle S, Van Dinh N, Vera Ayala CE, Zalewska-Janowska A, Zanichelli A, Magerl M, Maurer M. Definition, acronyms, nomenclature, and classification of angioedema (DANCE): AAAAI, ACAAI, ACARE, and APAAACI DANCE consensus. J Allergy Clin Immunol 2024:S0091-6749(24)00407-X. [PMID: 38670233 DOI: 10.1016/j.jaci.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, may occur only once or be recurrent, may exhibit wheals or not, and may be due to mast cell mediators, bradykinin, or other mechanisms. Several different taxonomic systems are currently used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize AE treatment. OBJECTIVE We developed a consensus on the definition, acronyms, nomenclature, and classification of AE (DANCE). METHODS The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific and medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022). RESULTS The DANCE initiative resulted in an international consensus on the definition, classification, and terminology of AE. The new consensus classification features 5 types and endotypes of AE and a harmonized vocabulary of abbreviations/acronyms. CONCLUSION The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic assessment and treatment of AE. DANCE does not replace current clinical guidelines, and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by physicians using sound clinical judgment. We anticipate that this new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.
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Affiliation(s)
- Avner Reshef
- Angioedema Research Center, Barzilai University Medical Center, Ashkelon, Israel.
| | - Thomas Buttgereit
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Stephen D Betschel
- Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Caballero
- Department of Allergy, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ-Group 44), Biomedical Research Network on Rare Diseases (CIBERER U754), Madrid, Spain; NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Anete S Grumach
- Department of Clinical Immunology, University Center Faculdade de Medicina do ABC, Santo André, Brazil
| | - Michihiro Hide
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ankur K Jindal
- Department of Pediatrics, Allergy Immunology Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Hilary Longhurst
- Department of Medicine, University of Auckland and Department of Immunology, Auckland City Hospital, Auckland, New Zealand
| | - Jonathan Peter
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Cape Town, and the Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Marc A Riedl
- Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, Calif
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Werner Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Mohamed Abuzakouk
- Allergy and Immunology, Respiratory Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tariq Al Farsi
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Nashat Al Sukaiti
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sabine Altrichter
- Klinik für Dermatologie und Venerologie, Kepler Uniklinikum, Linz, Austria
| | - Emel Aygören-Pürsün
- Department of Pediatrics, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Maria Luisa Baeza
- Allergy Department, Hospital General Universitario Gregorio Marañón, Biomedical Research Network on Rare Diseases-U761, Gregorio Marañón Health Research Institute (IiSGM), Gregorio Marañón, Madrid, Spain
| | - Noemi Anna Bara
- Romanian Hereditary Angioedema Expertise Centre, Centrul Clinic Mediquest, Sângeorgiu de Mure, Romania
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, Cincinnati, Ohio
| | | | - Hanna Bonnekoh
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Laurence Bouillet
- National Reference Center of Angioedema CREAK, Grenoble, France; Internal medicine department, Grenoble University Hospital, Grenoble, France
| | - Zenon Brzoza
- Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
| | | | | | - Freya Helena Campos Romero
- Department of Allergy and Clinical Immunology, Hospital Central Sur Alta Especialidad, Mexico City, Mexico City, Mexico
| | - Mauro Cancian
- Departmental Unit of Allergology, University Hospital of Padua, Padua, Italy
| | - Herberto Jose Chong-Neto
- Serviço de Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - George Christoff
- Excelsior Medical Centre, Sofia, Bulgaria; Medical University-Sofia, Sofia, Bulgaria
| | | | - Danny M Cohn
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Timothy Craig
- Department of Pediatrics, Pennsylvania State University, Hershey, Pa
| | | | - Razvigor Darlenski
- Department of Dermatovenereology, Trakia University, Stara Zagora, Bulgaria
| | - Aurélie Du-Thanh
- Département de dermatologie, ACARE, Centre Hospitalier Universitaire de Montpellier Montpellier, France
| | | | - Daria Fomina
- Moscow City Research and Practical Center of Allergoloy and Immunology, Clinical Hospital No. 52, Moscow Healthcare Department, Moscow, Russia
| | - Luz Fonacier
- New York University-Long Island School of Medicine, Mineola, NY
| | - Atsushi Fukunaga
- Department of Dermatology, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Asli Gelincik
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pedro Giavina-Bianchi
- Division of Clinical lmmunology and Allergy, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Kiran Godse
- Dr D. Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India
| | - Mark Gompels
- Department of Immunology, ACARE, North Bristol NHS Trust, Bristol, United Kingdom
| | - Margarida Goncalo
- Department of Dermatology, Coimbra Hospital and University Center, and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maia Gotua
- Center of Allergy and Immunology and David Tvildiani Medical University, Tbilisi, Georgia
| | | | - Mar Guilarte
- Allergy Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria and Angioedema and Department of Clinical Allergology and Urticaria, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Pavel Kolkhir
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marcin Kurowski
- Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland
| | - Elena Latysheva
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - Antti Lauerma
- Department of Dermatology, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - David Launay
- University Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Angioedemes à Kinine (CREAK), U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Ramon Lleonart
- Allergology Department, Hospital Universitari Bellvitge, IDIBILL Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Alejandro Malbran
- Unidad de Alergia, Asma e Inmunología Clínica, Buenos Aires, Argentina
| | - Ramzy Mohammed Ali
- Department of Medicine, Allergy and Immunology Division, Hamad Medical Corporation, Doha, Qatar
| | - Iman Nasr
- Immunology and Allergy Department, The Royal Hospital, Muscat, Oman
| | - Sandra Nieto-Martinez
- Unidad de Genética de la Nutrición, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Claudio Parisi
- Pediatric and Adult Allergy sections of the Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | | | | | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | - Alicia Prieto Garcia
- Department of Allergy, Gregorio Marañón Health Research Institute (IiSGM), Gregorio Marañón University Hospital, Madrid, Spain
| | - Polina Pyatilova
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Michael Rudenko
- The London Allergy and Immunology Centre, London, United Kingdom
| | | | - Faradiba Sarquis Serpa
- Angioedema and Urticaria Reference Center, Hospital Santa Casa de Misericórdia de Vitória, Vitória, Espirito Santo, Brazil
| | | | - Frank Siebenhaar
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Angèle Soria
- Médecine Sorbonne Université, Service de Dermatologie et Allergologie, hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Maria Staevska
- Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska" Sofia, Bulgaria
| | - Petra Staubach
- Department of Dermatology, ACARE, University Medical Center Mainz, Mainz, Germany
| | - Marcin Stobiecki
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Anna Valerieva
- Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska" Sofia, Bulgaria
| | - Solange Valle
- Department of Internal Medicine, Immunology Service, Hospital Universitario Clementino Fraga Filho, Rio De Janiero, Brazil
| | - Nguyen Van Dinh
- Department of General Internal Medicine, Respiratory-Allergy and Clinical Immunology Unit, Vinmec Healthcare System, Hanoi, Vietnam
| | - Carolina Elisa Vera Ayala
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | | | - Andrea Zanichelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Operative Unit of Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Markus Magerl
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Marcus Maurer
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
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Medina I, Josviack D, Berardi A, Cavallo C, Chinigo M, Chorzepa G, Fueyo G, García M, Onetti C, Vázquez D. [Health related to quality life of patients with hereditary angioedema in Argentina. A multicenter study]. REVISTA ALERGIA MÉXICO 2023; 70:64-71. [PMID: 37566769 DOI: 10.29262/ram.v70i2.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE To describe health relaed quality of life in a cohort of stable adult outpatients with hereditary an-gioedema (HAE) with validated tools. METHODS An observational, cross-sectional, and descriptive study was performed, carried out in patients with hereditary angioedema, coming from the City of Buenos Aires and its provinces: Corrientes, Chubut, Entre Ríos and Santa Fe. The HAE-QoL and SF-12v2 health questionnaires were applied to assess the related quality of life. with health. RESULTS 100 patients were included; median age: 41.5 years (range: 18-77); 65% were female, and 79% had type 1 HAE. Asymptomatic, mild, moderate and severe cases accounted for 6, 29, 38, and 27% of participants, respectively. Seventeen percent of patients were receiving long-term prophylaxis. Icatibant was the most fre-quent treatment for acute episodes. All health domains SF-12v2 scores were lower than expected in general population, excepting "vitality" and "physical functioning". Total and all specific domains HAE-QoL scores were reduced. Differences between women and men and in every age-defined group were demonstrated for sev-eral specific domains. CONCLUSIONS Health relaed to quality life was notably reduced in Argentinean patients with HAE, when imple-menting the HAE.QoL, and SF-12v2 questionnaries. The need for multidisciplinary strategies approaching this complex disease is highlighted.
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Affiliation(s)
- Iris Medina
- Centro Médico Vitae, 9 de Julio, Buenos Aires, Argentina.
| | - Darío Josviack
- Instituto de Medicina Respiratoria, Rafaela, Santa Fe, Argentina
| | - Alejandro Berardi
- Instituto de Asma, Alergia y Enfermedades Respiratorias, Corrientes, Argentina
| | | | - Marcela Chinigo
- Hospital Interzonal Especializado de Agudos y Crónicos San Juan de Dios, La Plata, Argentina
| | | | | | | | - Cora Onetti
- Hospital General De Agudos José María Penna, Buenos Aires, Argentina
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5
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Jahanshahi R, Yasaghi Z, Mirzaei F, Ghasemi S, Sanagoo A, Jouybari L, Foji S. Burden of adult neurofibromatosis 1 questionnaire: translation and psychometric properties of the Persian version. Orphanet J Rare Dis 2023; 18:161. [PMID: 37353850 DOI: 10.1186/s13023-023-02681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/02/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND The notion of "burden" has taken a key place in the evaluation of care, particularly in the case of rare diseases. The aim of this study was to evaluate the psychometric properties of the burden of neurofibromatosis 1 questionnaire (BoN) and to determine the perceived disease burden. RESULTS The 15-item BoN was translated into Persian, and no items were removed based on content validity. The adequacy of the sample was acceptable (KMO = 0.902), and Bartlett's test of sphericity revealed statistically significant results (P < 0.001). Exploratory factor analysis revealed three factors. The reliability of the scale was good (Cronbach's alpha: 0.90), and the intraclass coefficient was 0.85. The severity of the burden of neurofibromatosis was moderate, and the total mean burden score was 33.12 ± 16.12. CONCLUSIONS The Persian version of the BoN is an acceptable tool in terms of structure and content, and it specifically assesses the practical aspects of daily activities for patients with neurofibromatosis.
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Affiliation(s)
- Reza Jahanshahi
- BSN, Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zahra Yasaghi
- Master of critical care nursing, school of nursing and midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Mirzaei
- DDS, Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shohreh Ghasemi
- DDS, MSc of Oral Surgery, Adjunct Clinical, Department of Augusta University, GA, Augusta, USA
| | - Akram Sanagoo
- School of nursing and midwifery, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Leila Jouybari
- School of nursing and midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Samira Foji
- School of Nursing and Midwifery, Sabzevar university of medical scinces, Sabzevar, Iran
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6
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Jamuar S, Palmer R, Dawkins H, Lee DW, Helmholz P, Baynam G. 3D facial analysis for rare disease diagnosis and treatment monitoring: Proof-Of-Concept plan for hereditary angioedema. PLOS DIGITAL HEALTH 2023; 2:e0000090. [PMID: 36947507 PMCID: PMC10032512 DOI: 10.1371/journal.pdig.0000090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/24/2023] [Indexed: 03/23/2023]
Abstract
Rare diseases pose a diagnostic conundrum to even the most experienced clinicians around the world. The technology could play an assistive role in hastening the diagnosis process. Data-driven methodologies can identify distinctive disease features and create a definitive diagnostic spectrum. The healthcare professionals in developed and developing nations would benefit immensely from these approaches resulting in quicker diagnosis and enabling early care for the patients. Hereditary Angioedema is one such rare disease that requires a lengthy diagnostic cascade ensuing massive patient inconvenience and cost burden on the healthcare system. It is hypothesized that facial analysis with advanced imaging and algorithmic association can create an ideal diagnostic peer to the clinician while assimilating signs and symptoms in the hospital. 3D photogrammetry has been applied to diagnose rare diseases in various cohorts. The facial features are captured at a granular level in utmost finer detail. A validated and proven algorithm-powered software provides recommendations in real-time. Thus, paving the way for quick and early diagnosis to well-trained or less trained clinicians in different settings around the globe. The generated evidence indicates the strong applicability of 3 D photogrammetry in association with proprietary Cliniface software to Hereditary Angioedema for aiding in the diagnostic process. The approach, mechanism, and beneficial impact have been sketched out appropriately herein. This blueprint for hereditary angioedema may have far-reaching consequences beyond disease diagnosis to benefit all the stakeholders in the healthcare arena including research and new drug development.
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Affiliation(s)
- Saumya Jamuar
- Genetics Service, KK Women's and Children's Hospital, Singapore
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore
| | - Richard Palmer
- School of Earth and Planetary Sciences, Curtin University, Perth, Australia
| | - Hugh Dawkins
- School of Medicine, The University of Notre Dame Australia, Sydney
- Division of Genetics, School of Biomedical Sciences, University of Western Australia
| | - Dae-Wook Lee
- APAC Rare Disease Medical Affairs, Takeda Pharmaceuticals (Asia Pacific) Pte Ltd, Singapore (at the time of manuscript development)
| | - Petra Helmholz
- School of Earth and Planetary Sciences, Curtin University, Perth, Australia
| | - Gareth Baynam
- School of Earth and Planetary Sciences, Curtin University, Perth, Australia
- Rare Care Centre, Perth Children's Hospital, Perth, Australia
- Western Australian Register of Developmental Anomalies and Genetic Services of WA, King Edward Memorial Hospital, Perth Australia
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7
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Yamamoto B, Honda D, Ohsawa I, Iwamoto K, Horiuchi T, Fukunaga A, Maehara J, Yamashita K, Hide M. Burden of illness seen in hereditary angioedema in Japanese patients: Results from a patient reported outcome survey. Intractable Rare Dis Res 2023; 12:35-44. [PMID: 36873666 PMCID: PMC9976089 DOI: 10.5582/irdr.2022.01130] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
Hereditary angioedema (HAE) is a potentially life-threatening rare disease, which is mainly caused by the deficiency or dysfunction of C1-esterase inhibitor, and characterized by spontaneous, recurrent episodes of edema in various parts of the body including internal organs and the laryngeal area. Delayed diagnosis and treatment increase the burdens and risks of this condition. The current study aimed to understand the burden of illness for HAE patients in Japan before and after diagnosis through a patient reported outcome survey. A survey instrument was distributed to 121 adult patients with HAE by a patient organization via HAE treating physicians between July and November in 2016. Seventy patients (57.9%) returned the questionnaire. Patients reported high levels of medical resource utilization, including emergency procedures and services. Episodes of receiving laparotomy were somewhat less after diagnosis with HAE than before, but no apparent difference in episodes of tracheotomy between before and after the diagnosis. The economic burden, including direct and indirect medical costs, was highest before diagnosis, but still perceived as substantial after diagnosis. Patients reported disruption of work and school life, with 40% reporting that they miss 10 or more days from work or education per year. Sixty percent of patients reported that HAE affected their daily activities. We concluded that HAE is associated with considerable physical, social, economic and psycho-social burdens even after diagnosis, and that higher attack frequency is associated with a heavy disease burden for patients in Japan.
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Affiliation(s)
- Beverley Yamamoto
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
- HAEJ registered NPO, Japan
- HAEi Registered Charity, USA
| | - Daisuke Honda
- HAEJ registered NPO, Japan
- Department of Nephrology, Chiba University Hospital, Chiba, Japan
- Address correspondence to:Daisuke Honda, Department of Nephrology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan. E-mail:
| | - Isao Ohsawa
- HAEJ registered NPO, Japan
- Department of Nephrology, Internal Medicine, Saiyu Soka Hospital, Saitama, Japan
| | - Kazumasa Iwamoto
- HAEJ registered NPO, Japan
- Iwamoto Dermatology & Allergology Clinic, Hiroshima, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyusyu University Beppu Hospital, Oita, Japan
| | - Atsushi Fukunaga
- Department of Dermatology, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Junichi Maehara
- Department of Acute Care & General Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Kouhei Yamashita
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Michihiro Hide
- HAEJ registered NPO, Japan
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Dermatology, Hiroshima Citizens Hospital, Hiroshima, Japan
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8
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Kesh S, Bernstein JA. Isolated Angioedema: A Review of Classification and Update on Management. Ann Allergy Asthma Immunol 2022; 129:692-702. [PMID: 35988876 DOI: 10.1016/j.anai.2022.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this article is to review the various types of angioedema including diagnosis and treatment. DATA SOURCES PubMed search of articles in the English language various types of angioedema STUDY SELECTION: Articles on the subject matter were selected and reviewed. RESULTS Herein, a case based approach is presented for discussing the major types of angioedema including: hereditary angioedema (HAE) TypesI/II and normal complement, acquired angioedema, Angiotensin converting enzyme (ACE) induced angioedema, as well as histaminergic and non-histaminergic angioedema. Emerging treatments of HAE including targets of pre-kalikrein, DNA vector technology replacing C1INH protein, and CRIPSR technology targeting PKK among many others are explored. In addition, other causes as well as mimickers of angioedema are briefly reviewed. Finally, a novel algorithm is proposed to help guide the treating physician through the work up and management of patients with suspected idiopathic angioedema unresponsive to conventional therapy with antihistamines. CONCLUSION Over the years, many strides have been made in both understanding the pathophysiology of various types of angioedema as well as expansion of treatment options. It is important for clinicians to be aware of current and emerging treatment options. We provide a novel practical algorithm to guide clinicians in challenging cases of idiopathic angioedema refractory to antihistamines.
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Affiliation(s)
- Susamita Kesh
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Immunology and Allergy
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section; Bernstein Allergy Group.
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ÇİFTÇİ B. The effect of coronavirus disease-2019 (COVID-19) according to gender on health-related quality of life. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1114579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: The purpose of this study was to evaluate the changes in health-related quality of life of hospitalized patients with the diagnosis of coronavirus disease-2019 (COVID-19) according to gender.
Material and Method: The medical records of 77 patients (37 females and 40 males) who were hospitalized for COVID-19 were examined. Sociodemographic features including age, gender, marital status, comorbid diseases, duration of hospitalization, the period after discharge, symptoms of COVID-19 disease were analyzed. Short Form 36 (SF-36) was applied to all patients for evaluating the health-related quality of life pre and post COVID-19.
Results: The median scores of physical function, bodily pain, vitality, social functioning and general health perceptions before COVID-19 were statistically significantly higher than the scores after COVID-19 in both gender. Social functioning and the scores were lower in females than males for pre and post COVID-19 period and the differences were statistically significant.
Conclusions: The findings of this study revealed that health-related quality of life is affected by COVID-19 for both genders, mostly females.
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Jean-Baptiste M, Itzler R, Prusty S, Supina D, Martin ML. The symptom experience of hereditary angioedema (HAE) patients beyond HAE attacks: literature review and clinician interviews. Orphanet J Rare Dis 2022; 17:232. [PMID: 35710442 PMCID: PMC9204898 DOI: 10.1186/s13023-022-02360-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary angioedema (HAE) is a genetic disorder characterized by re-occurring swelling episodes called "attacks," usually in the limbs, face, airways, and intestinal tract. New prophylactic therapies have reduced the frequency of these attacks. This study describes results from a literature review and clinician interviews assessing patient HAE symptom experiences and timing, and then evaluates whether existing patient-reported outcome (PRO) tools adequately reflect this experience. METHODS A targeted literature review as well as interviews with key opinion leaders (KOLs), were conducted to capture information about the patient experience and their symptoms. An assessment of various PROs was then conducted to determine how well they each covered HAE symptoms and impacts. RESULTS Nineteen HAE symptoms were identified. KOLs reported that patients on prophylactic therapy experienced some symptoms indicating an attack was imminent, but then never experienced an attack. The comparison of the different PROs found that the Hereditary Angioedema Patient-Reported Outcome was the instrument that most thoroughly examined the symptoms of patients with HAE. CONCLUSIONS Given the introduction of new prophylactic therapies, further research is needed to determine the effect of being attack-free for longer periods of time on health-related quality of life.
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Affiliation(s)
| | | | | | - Dylan Supina
- Jazz Pharmaceuticals (Formerly CSL Behring), King of Prussia, PA, USA
| | - Mona L Martin
- Evidera, 615 2nd Ave Ste 500, Seattle, WA, 98104, USA.
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11
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Palao-Ocharan P, Prior N, Pérez-Fernández E, Caminoa M, Caballero T. Psychometric study of the SF-36v2 in hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE). Orphanet J Rare Dis 2022; 17:88. [PMID: 35236380 PMCID: PMC8889710 DOI: 10.1186/s13023-022-02202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The generic 36-item Short-Form Health Survey (SF-36v2) has been used to assess health related quality of life in adult patients with hereditary angioedema due to C1-inhibitor deficiency (C1-INH-HAE) even though it has not yet been validated for use in this specific disease. OBJECTIVE This study aims to validate the SF-36v2 for use in adult patients with C1-INH-HAE. RESULTS There was a very low item non-response rate (1-3.4%), with a high ceiling effect in 25/35 items and a low floor effect in 3/35 items. A moderate ceiling effect was observed in 5/8 dimensions of the SF-36v2, whereas no floor effect was noticed in any of the dimensions. Internal consistency was good to excellent with Cronbach's alpha coefficient ranging between 0.82 and 0.93 for the different dimensions. Construct validity was good: seven out of the 8 hypotheses defined on clinical criteria were confirmed, discriminant validity assessment showed significant differences among patients with different C1-INH-HAE severity, convergent validity showed a good correlation among the physical and mental component summaries of the SF-36v2 and the HAE-QoL total score (0.45 and 0.64 respectively, P < 0.001). Test-retest reliability was high with intraclass correlation coefficient varying from 0.758 to 0.962. The minimal clinically important difference was calculated by distribution methods and small differences in the domain scores and in the component summaries scores were shown to be meaningful. CONCLUSIONS: The psychometric properties of the SF-36v2 show it can be a useful tool to assess HRQoL in adult patients with C1-INH-HAE, although with some content validity limitation. METHODS The psychometric properties of the SF-36v2 were evaluated in an international setting based on responses from 290 adult C1-INH-HAE patients in 11 countries.
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Affiliation(s)
| | - Nieves Prior
- Allergy Department, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | | | | | - Teresa Caballero
- Allergy Department, Hospital Universitario La Paz, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPaz), Madrid, Spain.,Biomedical Research Network On Rare Diseases (CIBERER, U754), Madrid, Spain
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12
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Maurer M, Magerl M, Betschel S, Aberer W, Ansotegui IJ, Aygören-Pürsün E, Banerji A, Bara NA, Boccon-Gibod I, Bork K, Bouillet L, Boysen HB, Brodszki N, Busse PJ, Bygum A, Caballero T, Cancian M, Castaldo AJ, Cohn DM, Csuka D, Farkas H, Gompels M, Gower R, Grumach AS, Guidos-Fogelbach G, Hide M, Kang HR, Kaplan AP, Katelaris CH, Kiani-Alikhan S, Lei WT, Lockey RF, Longhurst H, Lumry W, MacGinnitie A, Malbran A, Martinez Saguer I, Matta Campos JJ, Nast A, Nguyen D, Nieto-Martinez SA, Pawankar R, Peter J, Porebski G, Prior N, Reshef A, Riedl M, Ritchie B, Sheikh FR, Smith WB, Spaeth PJ, Stobiecki M, Toubi E, Varga LA, Weller K, Zanichelli A, Zhi Y, Zuraw B, Craig T. The international WAO/EAACI guideline for the management of hereditary angioedema – The 2021 revision and update. World Allergy Organ J 2022; 15:100627. [PMID: 35497649 PMCID: PMC9023902 DOI: 10.1016/j.waojou.2022.100627] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/05/2021] [Accepted: 12/21/2021] [Indexed: 12/21/2022] Open
Abstract
Hereditary Angioedema (HAE) is a rare and disabling disease for which early diagnosis and effective therapy are critical. This revision and update of the global WAO/EAACI guideline on the diagnosis and management of HAE provides up-to-date guidance for the management of HAE. For this update and revision of the guideline, an international panel of experts reviewed the existing evidence, developed 28 recommendations, and established consensus by an online DELPHI process. The goal of these recommendations and guideline is to help physicians and their patients in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2), by providing guidance on common and important clinical issues, such as: 1) How should HAE be diagnosed? 2) When should HAE patients receive prophylactic on top of on-demand treatment and what treatments should be used? 3) What are the goals of treatment? 4) Should HAE management be different for special HAE patient groups such as children or pregnant/breast feeding women? 5) How should HAE patients monitor their disease activity, impact, and control? It is also the intention of this guideline to help establish global standards for the management of HAE and to encourage and facilitate the use of recommended diagnostics and therapies for all patients.
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13
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Maurer M, Magerl M, Betschel S, Aberer W, Ansotegui IJ, Aygören‐Pürsün E, Banerji A, Bara N, Boccon‐Gibod I, Bork K, Bouillet L, Boysen HB, Brodszki N, Busse PJ, Bygum A, Caballero T, Cancian M, Castaldo A, Cohn DM, Csuka D, Farkas H, Gompels M, Gower R, Grumach AS, Guidos‐Fogelbach G, Hide M, Kang H, Kaplan AP, Katelaris C, Kiani‐Alikhan S, Lei W, Lockey R, Longhurst H, Lumry WB, MacGinnitie A, Malbran A, Martinez Saguer I, Matta JJ, Nast A, Nguyen D, Nieto‐Martinez SA, Pawankar R, Peter J, Porebski G, Prior N, Reshef A, Riedl M, Ritchie B, Rafique Sheikh F, Smith WR, Spaeth PJ, Stobiecki M, Toubi E, Varga LA, Weller K, Zanichelli A, Zhi Y, Zuraw B, Craig T. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update. Allergy 2022; 77:1961-1990. [PMID: 35006617 DOI: 10.1111/all.15214] [Citation(s) in RCA: 137] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022]
Abstract
Hereditary angioedema (HAE) is a rare and disabling disease for which early diagnosis and effective therapy are critical. This revision and update of the global WAO/EAACI guideline on the diagnosis and management of HAE provides up-to-date guidance for the management of HAE. For this update and revision of the guideline, an international panel of experts reviewed the existing evidence, developed 28 recommendations, and established consensus by an online DELPHI process. The goal of these recommendations and guideline is to help physicians and their patients in making rational decisions in the management of HAE with deficient C1 inhibitor (type 1) and HAE with dysfunctional C1 inhibitor (type 2), by providing guidance on common and important clinical issues, such as: (1) How should HAE be diagnosed? (2) When should HAE patients receive prophylactic on top of on-demand treatment and what treatments should be used? (3) What are the goals of treatment? (4) Should HAE management be different for special HAE patient groups such as children or pregnant/breast-feeding women? and (5) How should HAE patients monitor their disease activity, impact, and control? It is also the intention of this guideline to help establish global standards for the management of HAE and to encourage and facilitate the use of recommended diagnostics and therapies for all patients.
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Affiliation(s)
- Marcus Maurer
- Institute of Allergology Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany
| | - Markus Magerl
- Institute of Allergology Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany
| | | | - Werner Aberer
- Department of Dermatology Medical University of Graz Graz Austria
| | | | - Emel Aygören‐Pürsün
- Center for Children and Adolescents University Hospital Frankfurt Frankfurt Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General Hospital Boston Massachusetts USA
| | - Noémi‐Anna Bara
- Romanian Hereditary Angioedema Expertise CentreMediquest Clinical Research Center Sangeorgiu de Mures Romania
| | - Isabelle Boccon‐Gibod
- National Reference Center for Angioedema (CREAK) Angioedema Center of Reference and Excellence (ACARE) Grenoble Alpes University Hospital Grenoble France
| | - Konrad Bork
- Department of Dermatology University Medical CenterJohannes Gutenberg University Mainz Germany
| | - Laurence Bouillet
- National Reference Center for Angioedema (CREAK) Angioedema Center of Reference and Excellence (ACARE) Grenoble Alpes University Hospital Grenoble France
| | | | - Nicholas Brodszki
- Department of Pediatric Immunology Childrens HospitalSkåne University Hospital Lund Sweden
| | | | - Anette Bygum
- Clinical Institute University of Southern Denmark Odense Denmark
- Department of Clinical Genetics Odense University Hospital Odense Denmark
| | - Teresa Caballero
- Allergy Department Hospital Universitario La PazIdiPaz, CIBERER U754 Madrid Spain
| | - Mauro Cancian
- Department of Systems Medicine University Hospital of Padua Padua Italy
| | | | - Danny M. Cohn
- Department of Vascular Medicine Amsterdam UMC/University of Amsterdam Amsterdam The Netherlands
| | - Dorottya Csuka
- Department of Internal Medicine and Haematology Hungarian Angioedema Center of Reference and Excellence Semmelweis University Budapest Hungary
| | - Henriette Farkas
- Department of Internal Medicine and Haematology Hungarian Angioedema Center of Reference and Excellence Semmelweis University Budapest Hungary
| | - Mark Gompels
- Clinical Immunology North Bristol NHS Trust Bristol UK
| | - Richard Gower
- Marycliff Clinical ResearchPrinciple Research Solutions Spokane Washington USA
| | | | | | - Michihiro Hide
- Department of Dermatology Hiroshima Citizens Hospital Hiroshima Japan
- Department of Dermatology Hiroshima University Hiroshima Japan
| | - Hye‐Ryun Kang
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
| | - Allen Phillip Kaplan
- Division of Pulmonary, Critical Care, Allergy and Immunology Medical university of South Carolina Charleston South Carolina USA
| | - Constance Katelaris
- Department of Medicine Campbelltown Hospital and Western Sydney University Sydney NSW Australia
| | | | - Wei‐Te Lei
- Division of Allergy, Immunology, and Rheumatology Department of Pediatrics Mackay Memorial Hospital Hsinchu Taiwan
| | - Richard Lockey
- Division of Allergy and Immunology Department of Internal Medicine Morsani College of MedicineUniversity of South Florida Tampa Florida USA
| | - Hilary Longhurst
- Department of Immunology Auckland District Health Board and Department of MedicineUniversity of Auckland Auckland New Zealand
| | - William B. Lumry
- Internal Medicine Allergy Division University of Texas Health Science Center Dallas Texas USA
| | - Andrew MacGinnitie
- Division of Immunology Department of Pediatrics Boston Children's HospitalHarvard Medical School Boston Massachusetts USA
| | - Alejandro Malbran
- Unidad de Alergia, Asma e Inmunología Clínica Buenos Aires Argentina
| | | | | | - Alexander Nast
- Department of Dermatology, Venereology and Allergology Division of Evidence‐Based Medicine Charité ‐ Universitätsmedizin Berlincorporate member of Free University of BerlinHumboldt University of Berlin, and Berlin Institute of Health Berlin Germany
| | - Dinh Nguyen
- Respiratory, Allergy and Clinical Immunology Unit Internal Medicine Department Vinmec Healthcare System College of Health SciencesVinUniversity Hanoi Vietnam
| | | | - Ruby Pawankar
- Department of Pediatrics Nippon Medical School Tokyo Japan
| | - Jonathan Peter
- Division of Allergy and Clinical Immunology University of Cape Town Cape Town South Africa
- Allergy and Immunology Unit University of Cape Town Lung Institute Cape Town South Africa
| | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology Jagiellonian University Medical College Krakow Poland
| | - Nieves Prior
- Allergy Hospital Universitario Severo Ochoa Madrid Spain
| | - Avner Reshef
- Angioderma CenterBarzilai University Medical Center Ashkelon Israel
| | - Marc Riedl
- Division of Rheumatology, Allergy and Immunology University of California San Diego La Jolla California USA
| | - Bruce Ritchie
- Departments of Medicine and Medical Oncology University of Alberta Edmonton AB Canada
| | - Farrukh Rafique Sheikh
- Section of Adult Allergy & Immunology Department of Medicine King Faisal Specialist Hospital & Research Centre Riyadh Saudi Arabia
| | - William R. Smith
- Clinical Immunology and Allergy Royal Adelaide Hospital Adelaide SA Australia
| | - Peter J. Spaeth
- Institute of PharmacologyUniversity of Bern Bern Switzerland
| | - Marcin Stobiecki
- Department of Clinical and Environmental Allergology Jagiellonian University Medical College Krakow Poland
| | - Elias Toubi
- Division of Allergy and Clinical Immunology Bnai Zion Medical CenterAffiliated with Rappaport Faculty of MedicineTechnion‐Israel Institute of Technology Haifa Israel
| | - Lilian Agnes Varga
- Department of Internal Medicine and Haematology Hungarian Angioedema Center of Reference and Excellence Semmelweis University Budapest Hungary
| | - Karsten Weller
- Institute of Allergology Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany
| | - Andrea Zanichelli
- Department of Internal Medicine ASST Fatebenefratelli Sacco Ospedale Luigi Sacco‐University of Milan Milan Italy
| | - Yuxiang Zhi
- Department of Allergy and Clinical Immunology Bejing Union Medical College Hospital & Chinese Academy of Medical Sciences Bejing China
| | - Bruce Zuraw
- University of California, San Diego San Diego California USA
| | - Timothy Craig
- Departments of Medicine and Pediatrics Penn State University Hershey Pennsylvania USA
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Radojicic C. Guidelines for management of hereditary angioedema: What is new? What is missing? Allergy Asthma Proc 2022; 43:12-19. [PMID: 34983705 DOI: 10.2500/aap.2022.43.210086] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Hereditary angioedema is an autosomal dominant disease that presents with recurrent episodic swelling of the submucosal and/or subcutaneous tissues of the cutaneous, gastrointestinal, and respiratory systems. Evaluation and treatment guidelines have been published nationally and internationally to aid the treating provider. Methods: A review of the most cited and most recent updated guidelines was undertaken to review key points and to explore real-world feasibility of incorporating them into clinical practice. The International World Allergy Organization/European Academy of Allergy and Clinical Immunology (WAO/EAACI) Guideline for the Management of Angioedema - The 2017 Revision and Update, and the consensus reports from the Hereditary Angioedema International Working Group, the Joint Task Force on Practice Parameters focused practice parameter update, and the most recently updated US HAEA Medical Advisory Board 2020 Guidelines for the Management of Hereditary Angioedema were reviewed and summarized. Results: Key points that have been consistent throughout the guidelines include recommendations for evaluation and classification of hereditary angioedema as well as evidence-based guidelines for treatment. Further attention is required on the evaluation and continuous assessment of the burden of illness and quality of life (QoL). Conclusion: The guidelines for management of hereditary angioedema provide a framework for the clinician. However, the physician-patient dialog with regard to the patient disease experience, which includes attack frequency, severity, and Qol, must be continually assessed.
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Di Agosta E, Salvati L, Corazza M, Baiardini I, Ambrogio F, Angileri L, Antonelli E, Belluzzo F, Bonamonte D, Bonzano L, Brancaccio R, Custurone P, De Marco A, Detoraki A, Di Guida A, Di Leo E, Fantò M, Fassio F, Ferrucci SM, Foti C, Gallo R, Gatta A, Guarneri F, Guidolin L, Hansel K, Lamacchia D, Lombardo C, Minciullo PL, Napolitano M, Pannofino A, Paravisi A, Parente R, Passante M, Patruno C, Peroni D, Quecchia C, Schettini N, Spadaro G, Stingeni L, Tarrini D, Tramontana M, Nettis E, Rossi O. Quality of life in patients with allergic and immunologic skin diseases: in the eye of the beholder. Clin Mol Allergy 2021; 19:26. [PMID: 34930291 PMCID: PMC8690422 DOI: 10.1186/s12948-021-00165-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 12/24/2022] Open
Abstract
Allergic and immunologic skin diseases negatively impact the quality of life (QoL) of affected patients with detrimental consequences. Nonetheless, in everyday clinical practice the evaluation of QoL is often overlooked. Considering the increasing prevalence of atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria, it is essential to determine the effects of allergic and immunologic skin diseases on QoL. A joint meeting (GET TOGETHER 2021) of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) aimed to summarize the features of the main QoL tools used in these diseases and to describe the extent of QoL impairment as well as the impact of treatments on QoL, particularly biologic therapies. The assessment of QoL in patients with allergic and immunologic skin diseases relies on generic, organ-specific and disease-specific questionnaires. While generic and organ-specific questionnaires allow comparison between different diseases, disease-specific questionnaires are designed and validated for specific cohorts: the QoL Index for Atopic Dermatitis (QoLIAD) and the Childhood Atopic Dermatitis Impact Scale (CADIS) in atopic dermatitis, the ACD-11 in allergic contact dermatitis, the Angioedema QoL Questionnaire (AE-QoL) and the Hereditary Angioedema QoL questionnaire (HAE-QoL) in hereditary angioedema, the Mastocytosis QoL Questionnaires (MCQoL e MQLQ) in cutaneous mastocytosis, and the Chronic Urticaria QoL questionnaire (CU-Q2oL) in urticaria. Among the many factors that variably contribute to QoL impairment, pruritus can represent the leading cause of patient discomfort. Biologic therapies significantly ameliorate QoL in atopic dermatitis, hereditary angioedema, mastocytosis and chronic urticaria. In general, adequate management strategies are essential for improving QoL in patients with allergic and immunologic skin diseases.
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Affiliation(s)
- Ester Di Agosta
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Lorenzo Salvati
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ilaria Baiardini
- Respiratory Unit for Continuity of Care, IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine (DiMI), University of Genoa, Genova, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Francesca Ambrogio
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Luisa Angileri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Elettra Antonelli
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - Domenico Bonamonte
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Laura Bonzano
- Dermatology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Raffaele Brancaccio
- Division of Allergy and Clinical Immunology, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Paolo Custurone
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Aurora De Marco
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Aikaterini Detoraki
- Department of Internal Medicine, Clinical Immunology, Clinical Pathology and Infectious Disease, Azienda Ospedaliera Universitaria Federico II, Napoli, Italy
| | - Adriana Di Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Elisabetta Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine-"F. Miulli" Hospital, Acquaviva Delle Fonti, Bari, Italy
| | - Marta Fantò
- Unit of Allergology, Department of Dermatology, Policlinico Umberto I, Hospital-University Sapienza of Rome, Roma, Italy
| | - Filippo Fassio
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Firenze, Italy
| | - Silvia Mariel Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Rosella Gallo
- Section of Dermatology - Department of Health Sciences, University of Genoa, Ospedale Policlinico San Martino - IRCCS, Genova, Italy
| | - Alessia Gatta
- Department of Medicine and Science of Ageing, G. d'Annunzio University, Chieti, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Lucia Guidolin
- Allergy Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Donatella Lamacchia
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Carla Lombardo
- Allergy Unit, Villa Igea Hospital. A.P.S.S. Trento, Trento, Italy
| | - Paola Lucia Minciullo
- Department of Clinical and Experimental Medicine, School and Division of Allergy and Clinical Immunology, University Hospital 'G. Martino', Messina, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Science "V. Tiberio", University of Molise, Campobasso, Italy
| | - Alessandro Pannofino
- Allergology and Immunology Clinic, Operative Unit of Medicine, Policoro Hospital, Policoro, Matera, Italy
| | - Andrea Paravisi
- Section of Dermatology, Department of Health Sciences, University of Genoa, Ospedale Policlinico San Martino - IRCCS, Genova, Italy
| | - Roberta Parente
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Maria Passante
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Diego Peroni
- Section of Pediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Cristina Quecchia
- Io e l'Asma Center, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Natale Schettini
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Napoli, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Daniele Tarrini
- Allergy and Clinical Immunology Unit, Department of Clinical Medicine, Mauriziano Umberto I Hospital, University of Turin, Torino, Italy
| | - Marta Tramontana
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - Oliviero Rossi
- Immunoallergology Unit, SOD Immunoallergologia, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
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Maurer M, Caballero T, Aberer W, Zanichelli A, Bouillet L, Bygum A, Grumach AS, Botha J, Andresen I, Longhurst HJ. Variability of disease activity in patients with hereditary angioedema type 1/2: longitudinal data from the Icatibant Outcome Survey. J Eur Acad Dermatol Venereol 2021; 35:2421-2430. [PMID: 34506666 DOI: 10.1111/jdv.17654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hereditary angioedema due to C1 inhibitor deficiency (HAE-1/2) is a chronic and debilitating disease. The unpredictable clinical course represents a significant patient burden. OBJECTIVE To analyse longitudinal registry data from the Icatibant Outcome Survey (IOS) in order to characterize temporal changes in disease activity in patients with HAE-1/2. METHODS Icatibant Outcome Survey (NCT01034969) is an international observational registry monitoring the clinical outcomes of patients eligible for icatibant treatment. The current analyses are based on data collected between July 2009 and July 2019. Retrospective data for attacks recorded in the 12 months prior to IOS enrolment and for each 12-month period up to 7 years were analysed. RESULTS Included patients reported angioedema attacks without long-term prophylaxis (LTP; n = 315) and with LTP (n = 292) use at the time of attack onset. Androgens were the most frequently used LTP option (80.8%). At the population level, regardless of LTP use, most patients (52-80%) reporting <5 attacks in Year 1 continued experiencing this rate; similarly, many patients (25-76%) who reported high attack frequency continued reporting ≥10 attacks/year. However, year on year, 31-51% of patients experienced notable changes (increase/decrease of ≥5 attacks) in annual attack frequency. Of patients who reported an absolute change of ≥10 attacks from Year 1 to 2, 17-50% continued to experience a change of this magnitude in subsequent years. CONCLUSION At the population level, attack frequency was generally consistent over 7 years. At the small group level, 28.8-34.5% of patients reported a change in attack frequency of ≥5 attacks from Year 1 to Year 2; up to half of these patients continued to experience this magnitude of variation in disease activity in later years, reflecting high intra-patient variability.
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Affiliation(s)
- M Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - T Caballero
- Department of Allergy, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | - W Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Zanichelli
- Department of Internal Medicine, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - L Bouillet
- National Reference Centre for Angioedema, Internal Medicine Department, Grenoble University Hospital, Grenoble, France
| | - A Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - A S Grumach
- Clinical Immunology, Medical School, University Center Health ABC, Santo Andre, Brazil
| | - J Botha
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - I Andresen
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - H J Longhurst
- Formerly Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Formerly University College London Hospitals, London, UK.,Auckland District Health Board, Auckland, New Zealand
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Ocak M, Nain E, Akarsu A, Sahiner UM, Sekerel BE, Soyer O. Health-related quality of life in children with hereditary angioedema compared with patients with histaminergic angioedema. Allergy Asthma Proc 2021; 42:325-332. [PMID: 34187624 DOI: 10.2500/aap.2021.42.210019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Hereditary angioedema (HAE) is a potentially life-threatening disease that remarkably impacts patients' health-related quality of life (HRQoL). This study evaluated the HRQoL in children with HAE and compared it with healthy controls and patients with histaminergic angioedema (HA). Methods: Fifty-nine children with HAE (median [interquartile range {IQR}], ages, 8.9 years [5.4-12.6 years]), 60 children with HA (median [IQR] ages, 10.3 years [8-15.4 years]), and 72 healthy controls (median [IQR] ages, 10.3 years [6.6-13.9 years]) were recruited. All the children and their families completed the age-adapted KINDL generic instrument for assessing health-related quality of life in children and adolescents. Results: The total HRQoL score and other subscales scores of both the patients with HAE and patients with HA, and the parent-proxy reports were significantly lower than those of the healthy children (p < 0.05). In the patients with HAE, the age at symptom onset was positively correlated with physical well-being (r = 0.335; p = 0.043) and negatively correlated with self-esteem (r = -0.324; p = 0.049). In addition, the physical well-being scores were affected by the site of attacks, which was significantly lower in the patients with abdominal pain attacks (p = 0.045). The family scores and total scores were statistically significantly higher in the HA group than the HAE group (p < 0.001 and p = 0.009, respectively). A significant correlation was found between self-report and parent-proxy HRQoLs in total and all subscales scores in the patients with HAE. For HA, there were no significant correlations for family scores. Conclusion: HAE caused significant impairment of the HRQoL of children and their families, and affected their lifestyle and quality of life. In pediatric patients with HAE, the HRQoL is mainly related to age at symptom onset and the site of attacks. Although patients with HAE are affected more negatively than the patients with HA, HA affected the quality of life as well.
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Affiliation(s)
- Melike Ocak
- From the Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey; and
| | - Ercan Nain
- Department of Pediatric Allergy, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Aysegul Akarsu
- From the Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey; and
| | - Umit Murat Sahiner
- From the Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey; and
| | - Bulent Enis Sekerel
- From the Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey; and
| | - Ozge Soyer
- From the Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey; and
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18
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Nicolas A, Launay D, Duprez C, Citerne I, Morell-Dubois S, Sobanski V, Hachulla É, Staumont-Sallé D, Farhat MM, Sanges S. [Impact of disease on daily activities, emotions and quality of life of patients with hereditary angioedema]. Rev Med Interne 2021; 42:608-615. [PMID: 34158189 DOI: 10.1016/j.revmed.2021.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/26/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Hereditary angioedema (HAE) is characterized by recurrent attacks of swelling of various locations and severity. An impaired quality of life of patients with HAE has been reported by several studies. We aimed at examining the overall impact of the disease in patients followed for type I HAE, particularly its impact on daily life activities, emotions and quality of life. METHODS A questionnaire was distributed to patients consulting for type I HAE, collecting demographics, disease characteristics, impact on professional life, Hospital Anxiety and Depression score (HAD), SF-36 score and the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR). RESULTS The 33 patients included reported an average of 5.17 attacks over the last year. Stress was the main trigger A long-term treatment was reported by 58% of patients, 72% received specific treatment in the event of a serious attack. Sick days were reported by 33% of patients during their studies, and by 34% during work. One patient suffered from depressive symptoms and ten from anxious symptoms, according to the HAD score. The areas most impacted on the SF-36 score were general health and vitality. The mean score for MACTAR was low. CONCLUSION HAE still has a significant impact on the daily and emotional lives of patients, despite the availability of prophylactic and crisis treatments.
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Affiliation(s)
- A Nicolas
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des angiœdèmes à Kinines, 59000 Lille, France
| | - D Launay
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des angiœdèmes à Kinines, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France
| | - C Duprez
- University Lille, UMR 9193 - SCALab - sciences cognitives et sciences affectives, 59000 Lille, France
| | - I Citerne
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des angiœdèmes à Kinines, 59000 Lille, France
| | - S Morell-Dubois
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France
| | - V Sobanski
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France
| | - É Hachulla
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France
| | - D Staumont-Sallé
- Centre de référence des angiœdèmes à Kinines, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Département de dermatologie, CHU Lille, 59000 Lille, France
| | - M-M Farhat
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des angiœdèmes à Kinines, 59000 Lille, France
| | - S Sanges
- Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des angiœdèmes à Kinines, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France.
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Bardakci MI, Ozturk EN, Ozkarafakili MA, Ozkurt H, Yanc U, Yildiz Sevgi D. Evaluation of long-term radiological findings, pulmonary functions, and health-related quality of life in survivors of severe COVID-19. J Med Virol 2021; 93:5574-5581. [PMID: 34032292 PMCID: PMC8242735 DOI: 10.1002/jmv.27101] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 12/30/2022]
Abstract
Objective It was aimed to evaluate long‐term radiological changes in severe coronavirus disease 2019 (COVID‐19) patients, to investigate pulmonary function, exercise capacities, and health‐related quality of life results. Methods Sixty‐five patients with severe COVID‐19 pneumonia were evaluated in the sixth month after discharge from the hospital. Spirometry, 6 min walking test (6MWT), and short form of health‐related quality of life scale (SF‐36) were applied in the sixth month. Chest computed tomography (CT) was performed and the findings were grouped according to lung involvement. Results Forty‐nine male and 16 female patients were included in the study. Forced expiratory volume in 1 s (FEV1)% values of 18 patients (30.5%), forced vital capacity (FVC)% values of 27 patients (45.8%), and 6MWT of 13 patients (23.2%) were found lower than expected in the sixth month. On the SF‐36 scale, physical function, energy‐vitality, social functionality, pain, and general health parameters were found lower than normal. Minimal interstitial changes in chest CT were seen in 26 patients. Nine patients had lung area involvement between 10% and 50% of the surface, there was a correlation between FEV1% and FVC% values in this group. There was severe pulmonary fibrosis in four patients. There was a correlation between pulmonary function and physical function and general perception of health from SF‐36 scale subparameters. Conclusion Functional and radiological abnormalities were detected in a significant number of patients in the sixth month after severe COVID‐19 pneumonia. A systematic monitoring plan must be established to assess and properly manage the long‐term problems that may arise.
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Affiliation(s)
- Mustafa Ilteris Bardakci
- Department of Chest Diseases, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esin Nagihan Ozturk
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mufide Arzu Ozkarafakili
- Department of Chest Diseases, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Huseyin Ozkurt
- Department of Radiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ugur Yanc
- Department of Radiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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20
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Maurer M, Aygören-Pürsün E, Banerji A, Bernstein JA, Balle Boysen H, Busse PJ, Bygum A, Caballero T, Castaldo AJ, Christiansen SC, Craig T, Farkas H, Grumach AS, Hide M, Katelaris CH, Li HH, Longhurst H, Lumry WR, Magerl M, Martinez-Saguer I, Riedl MA, Zhi Y, Zuraw B. Consensus on treatment goals in hereditary angioedema: A global Delphi initiative. J Allergy Clin Immunol 2021; 148:1526-1532. [PMID: 34048855 DOI: 10.1016/j.jaci.2021.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/06/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) is a rare, life-threatening genetic disorder characterized by recurrent episodes of subcutaneous or submucosal angioedema. The ultimate goals of treatment for HAE remain ill-defined. OBJECTIVES The aim of this Delphi process was to define the goals of HAE treatment and to examine which factors should be considered when assessing disease control and normalization of the patient's life. METHODS The Delphi panel comprised 23 participants who were selected based on involvement with scientific research on HAE or coauthorship of the most recent update and revision of the World Allergy Organization/European Academy of Allergy and Clinical Immunology guideline on HAE. The process comprised 3 rounds of voting. The final round aimed to aggregate the opinions of the expert panel and to achieve consensus. RESULTS Two direct consensus questions were posed in round 2, based on the responses received in round 1, and the panel agreed that the goals of treatment are to achieve total control of the disease and to normalize the patient's life. For the third round of voting, 21 statements were considered, with the participants reaching consensus on 18. It is clear from the wide-ranging consensus statements that the burdens of disease and treatment should be considered when assessing disease control and normalization of patients' lives. CONCLUSIONS The ultimate goal for HAE treatment is to achieve no angioedema attacks. The availability of improved treatments and disease management over the last decade now makes complete control of HAE a realistic possibility for most patients.
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Affiliation(s)
- Marcus Maurer
- Angioedema Center of Reference and Excellence, Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Emel Aygören-Pürsün
- Department of Children and Adolescents, University Hospital Frankfurt, Frankfurt, Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Jonathan A Bernstein
- Department of Medicine, Division of Immunology/Allergy Section, University of Cincinnati, Cincinnati, Ohio
| | | | - Paula J Busse
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Teresa Caballero
- Allergy Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Centre for Biomedical Network Research on Rare Diseases, Madrid, Spain
| | | | - Sandra C Christiansen
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif
| | - Timothy Craig
- Department of Medicine, Pediatrics and Graduate Studies, Penn State University, Hershey, Pa
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Anete S Grumach
- Clinical Immunology, Faculdade de Medicina, Centro Universitário Saude ABC, São Paulo, Brazil
| | - Michihiro Hide
- Department of Dermatology, Hiroshima University, Hiroshima, Japan
| | - Constance H Katelaris
- Department of Medicine, Campbelltown Hospital and Western Sydney University, Campbelltown, Australia
| | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Md
| | - Hilary Longhurst
- Auckland City Hospital, Auckland, New Zealand; University College Hospital, London, United Kingdom
| | - William R Lumry
- Department of Internal Medicine, Allergy/Immunology Division, Southwestern Medical School, University of Texas, Dallas, Tex; Allergy and Asthma Research Association Research Center, Dallas, Tex
| | - Markus Magerl
- Angioedema Center of Reference and Excellence, Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Marc A Riedl
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif
| | - Yuxiang Zhi
- Department of Allergy and Clinical Immunology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Disease, Beijing, China
| | - Bruce Zuraw
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif; San Diego Veterans Affairs Healthcare, San Diego, Calif
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21
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Bork K, Anderson JT, Caballero T, Craig T, Johnston DT, Li HH, Longhurst HJ, Radojicic C, Riedl MA. Assessment and management of disease burden and quality of life in patients with hereditary angioedema: a consensus report. Allergy Asthma Clin Immunol 2021; 17:40. [PMID: 33875020 PMCID: PMC8056543 DOI: 10.1186/s13223-021-00537-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary angioedema (HAE) is a rare disease characterized by unpredictable, potentially life-threatening attacks, resulting in significant physical and emotional burdens for patients and families. To optimize care for patients with HAE, an individualized management plan should be considered in partnership with the physician, requiring comprehensive assessment of the patient's frequency and severity of attacks, disease burden, and therapeutic control. Although several guidelines and consensus papers have been published concerning the diagnosis and treatment of HAE, there has been limited specific clinical guidance on the assessment of disease burden and quality of life (QoL) in this patient population. Practical guidance is critical in supporting effective long-term clinical management of HAE and improving patient outcomes. The objective of this review is to provide evidence-based guidelines for an individualized assessment of disease burden and QoL in patients with HAE. METHODS A consensus meeting was held on February 29, 2020, consisting of 9 HAE experts from the United States and Europe with extensive clinical experience in the treatment of HAE. Consensus statements were developed based on a preliminary literature review and discussions from the consensus meeting. RESULTS Final statements reflect the consensus of the expert panel and include the assessment of attack severity, evaluation of disease burden, and long-term clinical management of HAE caused by C1-esterase inhibitor deficiency. Patient-reported outcome measures for assessing HAE attack severity and frequency are available and valuable tools; however, attack frequency and severity are insufficient markers of disease severity unless they are evaluated in the broader context of the effect on an individual patient's QoL. QoL assessments should be individualized for each patient and minimally, they should address the interference of HAE with work, school, social, family, and physical activity, along with access to and burden of HAE treatment. Advances in HAE therapies offer the opportunity for comprehensive, individualized treatment plans, allowing patients to achieve minimal attack burden with reduced disease and treatment burden. CONCLUSION This consensus report builds on existing guidelines by expanding the assessment of disease burden and QoL measures for patients with HAE.
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Affiliation(s)
- Konrad Bork
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - John T Anderson
- Clinical Research Center of Alabama, 504 Brookwood Boulevard, Suite 250, Birmingham, AL, 35209, USA
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Paseo Castellana 261, 28406, Madrid, Spain
| | - Timothy Craig
- Department of Medicine and Pediatrics, Penn State University, 200 Campus Drive, Suite 1300, Entrance 4, Hershey, University Park, PA, 17033, USA
| | - Douglas T Johnston
- Asthma and Allergy Specialists, 8405 Providence Road, Suite 300, Charlotte, NC, 28277, USA
| | - H Henry Li
- Institute for Asthma and Allergy, 2 Wisconsin Circle, Suite 250, Chevy Chase, MD, 20815, USA
| | - Hilary J Longhurst
- Addenbrookes Hospital, Cambridge Universities NHS Foundation Trust, Cambridge and University College Hospital London, Cambridge, CB2 0QQ, UK
| | - Cristine Radojicic
- Division of Allergy and Clinical Immunology, Department of Medicine, Duke University, 1821 Hillandale Rd, Durham, NC, 27705, USA
| | - Marc A Riedl
- University of California San Diego, 8899 University Center Ln, San Diego, CA, 92122, USA
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Randomized Trial of the Efficacy and Safety of Berotralstat (BCX7353) as an Oral Prophylactic Therapy for Hereditary Angioedema: Results of APeX-2 Through 48 Weeks (Part 2). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2305-2314.e4. [PMID: 33866032 DOI: 10.1016/j.jaip.2021.03.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Berotralstat (BCX7353) is a recently approved, oral, once-daily kallikrein inhibitor for hereditary angioedema (HAE) prophylaxis. In the APeX-2 trial, berotralstat reduced HAE attack rates over 24 weeks, with a favorable safety and tolerability profile. OBJECTIVE Evaluate berotralstat safety, tolerability, and effectiveness over 48 weeks. METHODS APeX-2 is a phase 3, parallel-group, multicenter trial (NCT03485911) in patients with HAE due to C1 esterase inhibitor deficiency. Part 1 was double-blind and placebo-controlled, with patients randomized to 24 weeks of berotralstat 150 mg, 110 mg, or placebo. In part 2, patients continued berotralstat the same dose or, if initially randomized to placebo, were rerandomized to berotralstat 150 mg or 110 mg through weeks 24 to 48. The primary end point was safety and tolerability. RESULTS One hundred eight patients received 1 or more doses of berotralstat in part 2. Treatment-emergent adverse events (TEAEs) occurred in 30 of 39 patients (77%) in the placebo group during part 1, and 25 of 34 patients (74%) re-randomized from placebo to berotralstat 110 mg or 150 mg in part 2, with drug-related TEAEs in 13 of 39 (33%), and 11 of 34 (32%) in the same groups. Most TEAEs were mild or moderate, with no serious drug-related TEAEs. The most common TEAEs were upper respiratory tract infections, abdominal pain, diarrhea, and vomiting. Mean (±standard error of the mean) monthly attack rates at baseline and week 48 were 3.06 (±0.25) and 1.06 (±0.25) in the berotralstat 150mg 48-week group and 2.97 (±0.21) and 1.35 (±0.33) in the berotralstat 110mg 48-week group. CONCLUSIONS The safety, tolerability, and effectiveness of berotralstat were maintained over 48 weeks of treatment.
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23
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Lumry WR, Weller K, Magerl M, Banerji A, Longhurst HJ, Riedl MA, Lewis HB, Lu P, Devercelli G, Jain G, Maurer M, Hébert J, Ritchie B, Sussman G, Yang WH, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz RH, Anderson J, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Li HH, Lockey RF, Lugar P, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Radojicic C, Rehman SM, Schwartz LB, Shapiro R, Sher E, Smith AM, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H. Impact of lanadelumab on health-related quality of life in patients with hereditary angioedema in the HELP study. Allergy 2021; 76:1188-1198. [PMID: 33258114 PMCID: PMC8247292 DOI: 10.1111/all.14680] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
Background An objective of the phase 3 HELP Study was to investigate the effect of lanadelumab on health‐related quality of life (HRQoL) in patients with hereditary angioedema (HAE). Methods Patients with HAE‐1/2 received either lanadelumab 150 mg every 4 weeks (q4wks; n = 28), 300 mg q4wks (n = 29), 300 mg every 2 weeks (q2wks; n = 27), or placebo (n = 41) for 26 weeks (days 0–182). The Angioedema Quality of Life Questionnaire (AE‐QoL) was administered monthly, consisting of four domain (functioning, fatigue/mood, fears/shame, nutrition) and total scores. The generic EQ‐5D‐5L questionnaire was administered on days 0, 98, and 182. Comparisons were made between placebo and (a) all lanadelumab‐treated patients and (b) individual lanadelumab groups for changes in scores (day 0–182) and proportions achieving the minimal clinically important difference (MCID, −6) in AE‐QoL total score. Results Compared with the placebo group, the lanadelumab total group demonstrated significantly greater improvements in AE‐QoL total and domain scores (mean change, −13.0 to −29.3; p < 0.05 for all); the largest improvement was in functioning. A significantly greater proportion of the lanadelumab total group achieved the MCID (70% vs 37%; p = 0.001). The lanadelumab 300 mg q2wks group had the highest proportion (81%; p = 0.001) and was 7.2 times more likely to achieve the MCID than the placebo group. Mean EQ‐5D‐5L scores at day 0 were high in all groups, indicating low impairment, with no significant changes at day 182. Conclusion Patients with HAE‐1/2 experienced significant and clinically meaningful improvements in HRQoL measured by AE‐QoL following lanadelumab treatment in the HELP Study.
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Affiliation(s)
- William R. Lumry
- Allergy Asthma Research Associates Research Center Dallas TX USA
| | - Karsten Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General HospitalHarvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation TrustCambridge, and University College London Hospitals London UK
| | - Marc A. Riedl
- Division of Rheumatology Allergy & Immunology University of California San Diego La Jolla CA USA
| | | | - Peng Lu
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | | | - Gagan Jain
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
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24
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Balla Z, Ignácz B, Varga L, Kőhalmi KV, Farkas H. How Angioedema Quality of Life Questionnaire Can Help Physicians in Treating C1-Inhibitor Deficiency Patients? Clin Rev Allergy Immunol 2021; 61:50-59. [PMID: 33660212 PMCID: PMC8282561 DOI: 10.1007/s12016-021-08850-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Abstract
The Angioedema Quality of Life Questionnaire (AE-QoL) is an angioedema (AE)-specific validated questionnaire, which surveys the quality of life of diagnosed patients. The questionnaire has been used in multiple clinical trials. Our aim was to investigate how the questionnaire can assist physicians in the everyday practice of following up and managing C1-inhibitor deficiency patients. In a prospective trial conducted in our center between 2016 and 2018, 125 hereditary angioedema and 10 diagnosed with acquired angioedema completed an AE-QoL during their annual follow-up visit. Laboratory indices (i.e., complement levels) were obtained for each patient. Statistical analysis comparing clinical data with QoL parameters was performed. Results of the analysis show that AE-QoL total score and number of AE attacks per year correlated well (r = 0.47; p < 0.0001). Women reached higher AE-QoL total score values than men, over a 3-year period (p = 0.0014). The highest AE-QoL total scores were reached by the 41–60-year age group; we obtained a similar result, when analyzing the four domains. No correlation was found between the AE-QoL total score and complement parameters. Patients with a negative correlation between AE-QoL total score and number of AE attacks had a positive correlation with psychologic attributes like fatigue/mood and fears/shame domains. Patients that acquired HAE showed a significant correlation between the annual number of AE attacks and the AE-QoL total scores (r = 0.46; p < 0.0001). The study establishes the use of AE-QoL as a clinical tool for follow-up which can help in the complex assessment of both hereditary and acquired HAE patients, and help to develop better therapeutic strategies.
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Affiliation(s)
- Zsuzsanna Balla
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
- School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Bettina Ignácz
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Lilian Varga
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Kinga Viktória Kőhalmi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
- Department of Rheumatology, Hospital of the Hospitaller Brothers of Saint John of God, Budapest, Hungary
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary.
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25
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Nunes FL, Ferriani MPL, Moreno AS, Langer SS, Maia LSM, Ferraro MF, Sarti W, Bessa Junior JD, Cunha D, Suffritti C, Dias MM, Januário YC, daSilva LLP, Aragon DC, Caballero T, Arruda LK. Decreasing Attacks and Improving Quality of Life through a Systematic Management Program for Patients with Hereditary Angioedema. Int Arch Allergy Immunol 2021; 182:697-708. [PMID: 33657571 DOI: 10.1159/000513896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/18/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Prevention of attacks is a major goal in management of patients with hereditary angioedema (HAE). We aimed to investigate the effects of a systematic intervention for HAE patients. METHODS Thirty-three patients with HAE with C1-inhibitor deficiency, belonging to a single family, participated in a management program coordinated by an allergist/immunologist. Angioedema attacks before intervention were ascertained by interviews and emergency room charts and recorded prospectively by patients or caregivers after enrollment. Mean number of attacks/month was compared at 12 months preintervention and 8 and 14 months within intervention. Patient-reported outcome instruments were used to assess quality of life, including HAE Quality of Life (HAE-QoL) questionnaire, psychological conditions, and work impairment, at baseline and 8 and 14 months within intervention. Data were stored in REDCap platform and analyzed by adjusted Bayesian models of double Poisson regression. RESULTS Mean number of attacks/month significantly decreased (95% credible interval [CrI] excluding 0) from 1.15 preintervention to 0.25 and 0.23, 8 and 14 months within intervention, with mean decreases of -0.89 (95% CrI: -1.21 to -0.58) and -0.92 (95% CrI: -1.22 to -0.60), respectively. HAE-QoL scores showed mean total increases of 15.2 (95% CrI: 1.23-29.77) and 26 (95% CrI: 14.56-39.02) at 8 and 14 months within the study, as compared to baseline, revealing marked improvement in quality of life. Significant increase in role-emotional and reduction of depression, stress, and anxiety were observed at 14 months. CONCLUSION A systematic approach integrating HAE-specific care with effective handling of psychological issues decreased the number of attacks and improved quality of life, targets for best practice in HAE.
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Affiliation(s)
- Fernanda Leonel Nunes
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mariana P L Ferriani
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Adriana S Moreno
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sarah S Langer
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luana S M Maia
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Maria Fernanda Ferraro
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Willy Sarti
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José de Bessa Junior
- Department of Surgery, State University of Feira de Santana, Feira de Santana, Brazil
| | - Deborah Cunha
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Chiara Suffritti
- Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, ASST-Fatebenefratelli-Sacco, Milano, Italy
| | - Marina M Dias
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Yunan C Januário
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luis L P daSilva
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Davi Casale Aragon
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | - L Karla Arruda
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil,
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26
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Banerji A, Anderson J, Johnston DT. Optimal Management of Hereditary Angioedema: Shared Decision-Making. J Asthma Allergy 2021; 14:119-125. [PMID: 33603408 PMCID: PMC7881782 DOI: 10.2147/jaa.s284029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/18/2020] [Indexed: 12/14/2022] Open
Abstract
All patients with hereditary angioedema (HAE) must have access to on-demand therapy to treat attacks and may benefit from prophylactic therapy to reduce the attack frequency. Treatment decisions should be individualized, based on patient preferences and needs. One method for facilitating individualized therapy is shared decision-making (SDM), a widely used methodology for making treatment decisions among multiple therapeutic options. We propose a three-phase “3D” model (Discover, Discuss, Decide) for SDM in HAE. The Discover phase focuses on improving the physician’s understanding of the patient’s needs and understanding of the available therapeutic choices. The Discuss phase considers the alternatives, allowing a collaborative, informed treatment selection in the Decision phase. The 3D model is an ongoing, iterative process based on the patient’s changing needs and response to therapy. Uncovering the patient’s therapy goals through appropriate questions during these phases can help uncover relevant information for treatment selection information. SDM based on the 3D model can be a beneficial tool for optimizing therapy in HAE. ![]()
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Affiliation(s)
- Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USA
| | - John Anderson
- Clinical Research Center of Alabama, Birmingham, AL, USA
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Shen S, Wang M, Dong J. Moxibustion therapy for chronic spontaneous urticaria: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23226. [PMID: 33181706 PMCID: PMC7668497 DOI: 10.1097/md.0000000000023226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is a common disease in clinical, and often recrudescent. However, sometimes Western medicine treatments such as antihistamines cannot completely control the symptoms of CSU; therefore, more effective and optimized treatments are needed. Numerous studies have confirmed that moxibustion therapy is effective in treating CSU. Given that no relevant systematic reviews and meta-analysis have been carried out, we set out to prove the effect of moxibustion therapy for CSU. METHODS This protocol will be conducted based on the PRISMA-P guidelines and comply with the recommendations of the Cochrane Collaboration Handbook for Systematic Reviews. We plan to search the subsequent databases: PubMed, Web of Science, EMBASE.com and Cochrane Library, China National Knowledge Infrastructure, WanFang Database, Chinese Science Journal Database, and China Biomedical Literature Database. The studies will be screened under the eligibility criterion. The quality of the studies will be assessed based on the Cochrane risk bias tool. Ultimately, Review Manager 5.3 will be used for statistical analysis. RESULTS This research will comprehensively evaluate the effectiveness of moxibustion therapy for CSU, and provide a more reasonable and effective treatment plan for CUS. CONCLUSION This research will bring new evidence for the efficacy of moxibustion therapy in the treatment of CSU and provide a basis for future clinical applications. INPLASY REGISTRATION NUMBER INPLASY2020100045.
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Affiliation(s)
- Sijia Shen
- Huashan Hospital Affiliated to Fudan University
| | - Meiling Wang
- 905 Hospital of People's Liberation Army Navy, Shanghai, People's Republic of China
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Busse PJ, Christiansen SC, Riedl MA, Banerji A, Bernstein JA, Castaldo AJ, Craig T, Davis-Lorton M, Frank MM, Li HH, Lumry WR, Zuraw BL. US HAEA Medical Advisory Board 2020 Guidelines for the Management of Hereditary Angioedema. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:132-150.e3. [PMID: 32898710 DOI: 10.1016/j.jaip.2020.08.046] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 01/29/2023]
Abstract
Scientific and clinical progress together with the development of effective novel therapeutic options has engendered multiple important changes in the diagnosis and management of hereditary angioedema (HAE). We now update and extend the 2013 United States Hereditary Angioedema Association Medical Advisory Board guidelines for the treatment and management of HAE. The guidelines are based on a comprehensive literature review with recommendations indicating both the strength of our recommendation and the quality of the underlying evidence. Guidelines are provided regarding the classification, diagnosis, on-demand treatment, prophylactic treatment, special considerations for women and children, development of a comprehensive management and monitoring plan, and assessment of burden of illness for both HAE due to C1 inhibitor deficiency and HAE with normal C1 inhibitor. Advances in HAE treatment now allow the development of management plans that can help many patients with HAE lead a normal life. Achieving this goal requires that physicians be familiar with the diagnostic and therapeutic transformations that have occurred in recent years.
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Affiliation(s)
- Paula J Busse
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Mount Sinai School of Medicine, New York, NY
| | - Sandra C Christiansen
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif
| | - Marc A Riedl
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Jonathan A Bernstein
- Division of Immunology, Rheumatology, and Allergy, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Timothy Craig
- Division of Allergy, Asthma, and Immunology, Department of Medicine, Pediatrics, and Graduate Studies, Pennsylvania State University, Hershey, Pa
| | - Mark Davis-Lorton
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Medicine, NYU Winthrop Hospital, Mineola, NY
| | - Michael M Frank
- Department of Pediatrics, Duke University Medical Center, Durham, NC
| | - H Henry Li
- Medicine Service, Institute for Asthma and Allergy, Chevy Chase, Md
| | - William R Lumry
- Allergy and Asthma Research Associates Research Center, Dallas, Tex
| | - Bruce L Zuraw
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif; San Diego Veterans Administration Healthcare, San Diego, Calif.
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Banerji A, Davis KH, Brown TM, Hollis K, Hunter SM, Long J, Jain G, Devercelli G. Patient-reported burden of hereditary angioedema: findings from a patient survey in the United States. Ann Allergy Asthma Immunol 2020; 124:600-607. [PMID: 32169514 DOI: 10.1016/j.anai.2020.02.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/07/2020] [Accepted: 02/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) with C1-inhibitor deficiency is associated with painful, potentially fatal attacks affecting subcutaneous or submucosal tissues. OBJECTIVE To evaluate HAE burden from the patients' perspective. METHODS This was a noninterventional survey of patients with HAE in the United States, conducted from March 17 to April 28, 2017. Patients were recruited through the US Hereditary Angioedema Association. Key eligibility criteria included the following: (1) aged 18 years and older, (2) self-reported physician diagnosis of HAE type I or II, (3) 1 or more HAE attacks or prodromal symptoms within the last year, and (4) receipt of HAE medication for an attack within the last 2 years. Descriptive analyses were conducted. RESULTS A total of 445 patients completed the survey. Most patients (92.8%) were aged 18 to 64 years with HAE type I (78.4%) and had a positive family history (78.4%). Mean (SD) ages at symptom onset and diagnosis were 12.5 (9.1) and 20.1 (13.7) years, respectively. Most patients (78.7%) experienced an attack within the past month. The abdomen (58.0%) and extremities (46.1%) were commonly affected sites; pain (73.9%) and abdominal (57.0%) and nonabdominal (55.1%) swelling were frequently reported symptoms. Most patients (68.5%) had received or were currently receiving long-term prophylaxis. Most patients (88.8%) reported visiting allergists or immunologists, whereas 9.2% visited emergency departments or urgent care clinics. Per the Hospital Anxiety and Depression Scale, 49.9% and 24.0% of respondents had anxiety and depression, respectively. Mean Hereditary Angioedema-Quality of Life scores were generally lower with higher attack frequency. General health was "poor" or "fair" for 24.8% of patients. Mean (SD) percentage impairments were 5.9% (14.1%) for absenteeism, 23.0% (25.8%) for presenteeism, 25.4% (28.1%) for work productivity loss, and 31.8% (29.7%) for activity impairment. CONCLUSION Despite treatment advances, patients with HAE in the United States continue to have a high burden of illness.
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Affiliation(s)
- Aleena Banerji
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | | | | | - Kelly Hollis
- RTI Health Solutions, Research Triangle Park, North Carolina
| | | | - Janet Long
- US Hereditary Angioedema Association (US HAEA), Fairfax City, Virginia
| | - Gagan Jain
- Shire, a Takeda company, Lexington, Massachusetts
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Chen KY, Li T, Gong FH, Zhang JS, Li XK. Predictors of Health-Related Quality of Life and Influencing Factors for COVID-19 Patients, a Follow-Up at One Month. Front Psychiatry 2020; 11:668. [PMID: 32733299 PMCID: PMC7360857 DOI: 10.3389/fpsyt.2020.00668] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/26/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To survey the health-related quality of life (HRQoL) and its influencing factors among patients with COVID-19 in their first medical follow up. METHODS All patients diagnosed with COVID-19 were discharged from 12 hospitals in Wenzhou, Zhejiang from Jan 17, 2020 to Mar 20, 2020. Prospectively collected and analyzed data included demographics, clinical symptoms, comorbidity, and chest CT imaging features at the first follow up, 1 month after discharge. All patients underwent the HRQoL evaluation with the Chinese version of Short-Form 36-item questionnaire (SF-36) as well as a general condition questionnaire. Factors associated with SF-36 were constructed using linear regression. Predictors of impaired physical component summary (PCS) and a mental component summary (MCS) were identified by logistic regression. RESULTS SF-36 demonstrated a significant difference in HRQoL in patients with COVID-19, except in physical function (PF), when compared to the general Chinese population (p<0.05). The multiple linear regressions demonstrated that age was negatively associated with PF, role physical (RP), but positively associated with vitality (VT) (p<0.05). PF, bodily pain (BP), and role-emotional (RE) were negatively associated with the female sex (p<0.05). For mental health, the clinical subtypes were significant associated factors (p < 0.05). Length of stay (LOS) was strongly negatively associated with RE and RP, and positively associated with VT (p< 0.05). Logistical regression revealed that non-obese overweight (OR 3.71) and obesity (OR 3.94) were risk factors for a low PCS and female sex (OR 2.22) was a risk factor for a low MCS. CONCLUSIONS Health-related quality of life was poor among COVID-19 patients at the 1 month follow-up. Patients suffered from significant physical and psychological impairment. Therefore, prospective monitoring of individuals exposed to SARS-CoV-2 is needed in order to fully understand the long-term impact of COVID-19, as well as to inform prompt and efficient interventions to alleviate suffering.
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Affiliation(s)
- Ke-Yang Chen
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ting Li
- Department of Anesthesia and Critical Care, and Clinical Research Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fang-Hua Gong
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jin-San Zhang
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China.,Institute of Life Sciences, Wenzhou University, Wenzhou, China
| | - Xiao-Kun Li
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
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Kulthanan K, Chularojanamontri L, Rujitharanawong C, Weerasubpong P, Maurer M, Weller K. Angioedema quality of life questionnaire (AE-QoL) - interpretability and sensitivity to change. Health Qual Life Outcomes 2019; 17:160. [PMID: 31655579 PMCID: PMC6815453 DOI: 10.1186/s12955-019-1229-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 10/02/2019] [Indexed: 02/07/2023] Open
Abstract
Background The Angioedema Quality of Life (AE-QoL) is the first patient reported outcome measure developed for the assessment of quality of life (QoL) impairment in patients with recurrent angioedema (RAE). This study aimed to evaluate the clinimetric properties of the AE-QoL in Thai patients and to establish categories of QoL impairment assessed by the AE-QoL. Methods The validated Thai version of the Dermatology Life Quality Index (DLQI) and Patient Global Assessment of Quality of Life (PGA-QoL) were used to comparatively evaluate the Thai version of AE-QoL. Spearman correlations between the Thai AE-QoL and two other standard measurements (DLQI and PGA-QoL) were investigated to determine convergent validity. The Thai DLQI and PGA-QoL were used to categorize patients according to their QoL. Known-group validity of the Thai AE-QoL was later analyzed. The reliability of the Thai AE-QoL was investigated using Cronbach’s alpha and intraclass correlation. Three different approaches including the distribution method, receiver operating characteristic curve analysis, and the anchor based-method were used for the interpretability. Results A total of 86 patients with RAE with a median age of 38.0 ± 15.1 years (range 18–76) were enrolled. Of those, 76 patients (88%) had RAE with concomitant wheals, and 10 patients (11.6%) had RAE only. The AE-QoL assessed RAE-mediated QoL impairment with high convergent validity and known-groups validity, high internal consistency and test-retest reliability, and good sensitivity to change. Although the AE-QoL did not differentiate between patients with moderate and large effect as measured by PGA-QoL or DLQI in this study, AE-QoL total values of 0–23, 24 to 38, and ≥ 39 could define patients with “no effect”, “small effect”, and “moderate to large effect” of RAE on their QoL, respectively. Conclusions This study supports the validity and reliability of the Thai version of the AE-QoL, which is a very different language from the original version. Categories allow to classify the effect of RAE on patients’ QoL as “none”, “small”, and “moderate to large”. Further studies are needed to confirm the applicability of AE-QoL in other Asian populations”.
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Affiliation(s)
- Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chuda Rujitharanawong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Puncharas Weerasubpong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Karsten Weller
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Liu S, Wang X, Xu Y, Xu Q, Zhi Y. Health-related quality of life and its risk factors in Chinese hereditary angioedema patients. Orphanet J Rare Dis 2019; 14:191. [PMID: 31395105 PMCID: PMC6686410 DOI: 10.1186/s13023-019-1159-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/18/2019] [Indexed: 01/29/2023] Open
Abstract
Background Hereditary angioedema (HAE) is a rare but serious condition characterized by unpredictable and recurrent attacks affecting the skin and mucosa. HAE has wide-ranging impacts on the health-related quality of life (HRQoL) of patients. This study aims to assess the HRQoL of Chinese patients with HAE using the 36-item Short Form Health Survey (SF-36v2) and to explore potential risk factors for low HRQoL. Methods A total of 104 patients (47 male and 57 female) over age 18 living in China with a known diagnosis of HAE due to C1-INH deficiency completed the SF-36v2 (generic HRQoL questionnaire). The results were compared to Chinese population norms. Subgroup analysis and logistic regression were used to interpret the data. Results SF-36v2 showed a significant reduction in all dimensions of HRQoL (p < 0.001) in patients with HAE compared with the general Chinese population. Female patients reported significantly lower bodily pain (BP) (p = 0.039) and physical component scores (PCSs) (p = 0.027) than male patients. Patients with mucosal edema tended to report lower role-physical (RP) limitations (p = 0.031) than patients with only skin edema. There were no differences between the mean scores of the SF-36 in relation to disease subtype, age, disease severity and long-term prophylaxis. Among female patients on long-term prophylaxis, social functioning (SF) (r = − 0.404, p = 0.010), role-emotional (RE) (r = − 0.320, p = 0.044) and mental component scores (MCSs) (r = − 0.313, p = 0.049) were negatively correlated with danazol dosage. A correlation between decreased disease control and decreased HRQoL scores was found, although the correlation was not significant in terms of RE or mental health (MH) scores. The logistic regression model revealed uncontrolled disease to be a risk factor for a low PCS (odds ratio 10.77, 95% confidence interval [CI] 1.78–65.06; p = 0.010) and laryngeal edema to be a risk factor for a low MCS (odds ratio 4.75, 95% CI 1.09–20.69; p = 0.038). Conclusions Chinese HAE patients reported significantly lower HRQoL scores than the general population. Unsatisfactory disease control is a risk factor for decreased PCSs. Laryngeal edema is a risk factor for decreased MCSs. Electronic supplementary material The online version of this article (10.1186/s13023-019-1159-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuang Liu
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.,School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.,Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yingyang Xu
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Busse PJ, Farkas H, Banerji A, Lumry WR, Longhurst HJ, Sexton DJ, Riedl MA. Lanadelumab for the Prophylactic Treatment of Hereditary Angioedema with C1 Inhibitor Deficiency: A Review of Preclinical and Phase I Studies. BioDrugs 2019; 33:33-43. [PMID: 30539362 PMCID: PMC6373397 DOI: 10.1007/s40259-018-0325-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hereditary angioedema (HAE) with C1 esterase inhibitor (C1-INH) deficiency (C1-INH-HAE) is a rare disease characterized by diminished levels or dysfunctional activity of C1-INH, leading to dysregulated plasma kallikrein activity within the kallikrein-kinin pathway. Symptoms manifest as painful, potentially life-threatening swelling of subcutaneous tissues throughout the body and/or submucosal edema in the upper airway or gastrointestinal tract. Attacks recur with unpredictable frequency, intensity, and duration, placing a heavy burden on patients' daily lives. Despite improved availability of medications for on-demand treatment during attacks and prophylaxis of future attacks, unmet needs remain. Lanadelumab, a fully human monoclonal antibody, may help address some of the limitations of existing prophylactic options (e.g., the need for intravenous administration or frequent dosing). Preclinical studies demonstrate that it is highly potent and specifically inhibits plasma kallikrein, and findings from phase Ia and Ib studies suggest this agent is well tolerated and provides sustained inhibition of plasma kallikrein, allowing for less frequent dosing. The phase III HELP Study (NCT02586805) evaluating the efficacy and safety of lanadelumab in preventing HAE attacks has been completed, and its open-label extension (NCT02741596) is ongoing. Lanadelumab is now approved in the USA and Canada for prophylaxis to prevent attacks of HAE in patients aged ≥ 12 years. This review provides an overview of the discovery and clinical development of lanadelumab, from preclinical through phase Ib studies, characterizing its safety/tolerability, efficacy, and pharmacokinetic and pharmacodynamic profiles. It also highlights how this agent may positively impact clinical care of patients with C1-INH-HAE.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Angioedemas, Hereditary/drug therapy
- Angioedemas, Hereditary/pathology
- Angioedemas, Hereditary/physiopathology
- Angioedemas, Hereditary/prevention & control
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Clinical Trials, Phase I as Topic
- Drug Evaluation, Preclinical
- Humans
- Middle Aged
- Plasma Kallikrein/antagonists & inhibitors
- Plasma Kallikrein/drug effects
- Young Adult
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Affiliation(s)
- Paula J Busse
- Division of Clinical Immunology and Allergy, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room 11-20, New York, NY, 10029, USA.
| | - Henriette Farkas
- Hungarian Angioedema Reference Center, 3rd Department of Internal Medicine, Semmelweis University, Kutvolgyi ut 4, Budapest, 1125, Hungary
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Cox 201, Boston, MA, 02114, USA
| | - William R Lumry
- Allergy and Asthma Research Associates, 10100 N. Central Expressway, Suite 100, Dallas, TX, 75231, USA
| | - Hilary J Longhurst
- Department of Immunology, Addenbrookes Hospital Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | | | - Marc A Riedl
- Division of Rheumatology, Allergy and Immunology, University of California, San Diego, 8899 University Center Lane, Suite 230, San Diego, CA, 92122, USA
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Zanichelli A, Magerl M, Longhurst HJ, Aberer W, Caballero T, Bouillet L, Bygum A, Grumach AS, Botha J, Andresen I, Maurer M. Improvement in diagnostic delays over time in patients with hereditary angioedema: findings from the Icatibant Outcome Survey. Clin Transl Allergy 2018; 8:42. [PMID: 30338053 PMCID: PMC6182796 DOI: 10.1186/s13601-018-0229-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 12/12/2022] Open
Abstract
The objective of this analysis was to evaluate the change over time in age at first symptoms, age at diagnosis, and delay in diagnosis using data from the Icatibant Outcome Survey (IOS). Patients with a diagnosis of C1-INH-HAE who were born before the year 1990 and who were diagnosed before they reached 25 years of age were included in the analysis. Both age at diagnosis and delay in diagnosis of C1-INH-HAE appear to decline with later decade of birth, despite wide variation across the countries assessed, suggesting that improved disease awareness causes increased rates of earlier diagnosis over time. Our findings demonstrate that some patients are still experiencing long delays to diagnosis, indicating an ongoing need for improved disease awareness.
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Affiliation(s)
- Andrea Zanichelli
- 1Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Markus Magerl
- 2Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hilary J Longhurst
- 3Department of Immunology, Barts Health NHS Trust, London, UK.,10Present Address: Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Werner Aberer
- 4Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Teresa Caballero
- 5Department of Allergy, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | - Laurence Bouillet
- 6National Reference Centre for Angioedema, Internal Medicine Department, Grenoble University Hospital, Grenoble, France
| | - Anette Bygum
- 7Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | | | | | | | - Marcus Maurer
- 2Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Zanichelli A, Azin GM, Cristina F, Vacchini R, Caballero T. Safety, effectiveness, and impact on quality of life of self-administration with plasma-derived nanofiltered C1 inhibitor (Berinert®) in patients with hereditary angioedema: the SABHA study. Orphanet J Rare Dis 2018; 13:51. [PMID: 29631595 PMCID: PMC5891972 DOI: 10.1186/s13023-018-0797-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary angioedema with C1 inhibitor deficiency is a disabling, potentially fatal condition characterized by recurrent episodes of swelling. Self-treatment is recommended, in order to reduce admissions to the Emergency Room and the time between the onset of the attack and the treatment, resulting in a better treatment outcome and an improved quality of life (QoL). The purpose of this study is to assess the safety, tolerability, and effect on QoL of self-administration of pnf C1-INH for IV use (Berinert®). METHODS An observational, monocenter, prospective study was designed. Patients referring to a center for angioedema that attended two sessions of self-infusion training course in the period March 2014-July 2015 were enrolled in the study. The primary endpoint was to monitor the safety and feasibility of pnf C1-INH self-infusion. The secondary endpoint was to evaluate the effect of self-infusion on the QoL, by means of the HAE-QoL questionnaire and the need for access to Emergency Room for infusion of Berinert®. Patients' medical history data were collected upon the first visit and questionnaires were filled after each attack treated with Berinert® (diary and Treatment Satisfaction Questionnaire for Medication) and upon the first visit and the follow-ups (HAE-QoL). RESULTS Twenty patients were enrolled (median age = 42, IQR: 39-49; 60% females). Fifteen patients completed the study. A total of 189 attacks were recorded (annual median rate of 4 attacks/patient). Patients waited a median of 2 h (IQR: 1-4) before self-administration, and the resolution of the attack occurred after a median of 6 h (IQR: 4-11). Most attacks were abdominal (39%) and peripheral (22%). 92% of the attacks were treated through self-/caregiver-administration. In most attacks no side effects were reported. The number of attacks with side effects decreased over time, from 37% to 13%. Global satisfaction grew over time during the study period, reaching statistical significance over the first 6 months. The median total HAE-QoL score at baseline was 86 (IQR: 76-103) and improved in a non-significant manner throughout the study period. 8% of the attacks treated with Berinert® required ER admission/healthcare professional help in the study period, compared with 100% in the 3 years before enrollment (p < 0.0001). CONCLUSIONS Self-administration of pnf C1-INH is safe, and increases patients' confidence in the treatment, showing also a trend towards an improvement in QoL. It reduces the need for ER admission/healthcare professionals help for the acute attacks, as well as the related costs.
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Affiliation(s)
- Andrea Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Giulia Maria Azin
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Federico Cristina
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Romualdo Vacchini
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research, Madrid, Spain
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Bygum A, Busse P, Caballero T, Maurer M. Disease Severity, Activity, Impact, and Control and How to Assess Them in Patients with Hereditary Angioedema. Front Med (Lausanne) 2017; 4:212. [PMID: 29255709 PMCID: PMC5722805 DOI: 10.3389/fmed.2017.00212] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/13/2017] [Indexed: 01/19/2023] Open
Abstract
Hereditary angioedema (HAE) is a group of rare, potentially life-threatening, and frequently debilitating diseases characterized by recurrent, and often with an unpredictable onset, of swelling attacks. HAE is heterogeneous, with considerable differences between its subtypes, patients, and even within the same patient over time. During the past few years, several new on demand and prophylactic therapies have become available for HAE, allowing for individualized treatment. Therefore, to optimize HAE management, it is important to determine in all patients, the severity of their attacks, their disease activity, its therapeutic control, and its impact on their quality of life. In this manuscript, we review the existing tools to assess these aspects of HAE management, many of which are patient-reported outcome instruments. Also, we outline the current gaps of knowledge and what tools are still missing to allow for a comprehensive assessment of all patients with HAE including children.
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Affiliation(s)
- Anette Bygum
- HAE Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Paula Busse
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), CIBERER U754, Madrid, Spain
| | - Marcus Maurer
- Department of Dermatology and Allergy, Charité – Universitätsmedizin Berlin, Berlin, Germany
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