Prophylaxis in hereditary angioedema : a United Kingdom Delphi consensus
Yong, Patrick F K Annals, Rachel Diwakar, Lavanya Elkhalifa, Shuayb Gompels, Mark Jain, Rashmi Karim, M Yousuf Khan, Sujoy Metcalfe, Angela Noorani, Sadia
Yong, Patrick F K
Annals, Rachel
Diwakar, Lavanya
Elkhalifa, Shuayb
Gompels, Mark
Jain, Rashmi
Karim, M Yousuf
Khan, Sujoy
Metcalfe, Angela
Noorani, Sadia
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Affiliation
Frimley Health NHS Foundation Trust; Hereditary Angioedema UK; University Hospital of North Midlands NHS Trust; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2024-03-08
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Abstract
Hereditary angioedema (HAE) is a rare inherited disorder causing recurrent of episodes of swelling that can be potentially life threatening. Treatment of HAE can be divided into on-demand treatment for swelling, and prophylaxis. The last UK consensus on HAE was in 2014 and since then, new medications for prophylaxis have been developed, with more drugs in the pipeline. International guidelines currently recommend the use of long-term prophylaxis (LTP) as the only way of achieving disease control and normalising patient lives. Modern prophylactic medications are available in the UK, although access is restricted primarily by HAE attack frequency. To establish an updated view of UK clinicians and patients, a Delphi process was used to develop statements regarding long-term prophylaxis as well as other aspects of HAE management. There was consensus that UK access criteria for modern LTP agents based on numerical frequency of attacks alone is too simplistic and potentially disadvantage a cohort of patients who may benefit from LTP. Additionally, there was agreement that patients should be seen in expert centres, remote monitoring of patients is popular post-pandemic, and that the use of patient reported outcome measures have the potential to improve patient care. Psychological health is an area in which patients may benefit, and recognition of this is important for future research and development.
Citation
Yong PFK, Annals R, Diwakar L, Elkhalifa S, Gompels M, Jain R, Karim MY, Khan S, Metcalfe A, Noorani S, Steele C, Kiani-Alikhan S, Garcez T. Prophylaxis in hereditary angioedema: a United Kingdom Delphi consensus. Clin Exp Immunol. 2024 Mar 8:uxae020. doi: 10.1093/cei/uxae020
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Article