Icatibant Outcome Survey in Patients with Hereditary Angioedema: Experience in Israel Compared with Other Countries.

Abstract

BACKGROUND:

Management of patients with hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) is evolving worldwide. Evaluating the Israeli experience may provide valuable insights.

OBJECTIVES:

To compare demographics and icatibant treatment patterns and outcomes in patients with C1-INH-HAE enrolled in the Icatibant Outcome Survey (IOS) in Israel with those in other countries.

METHODS:

The IOS is an ongoing observational study that prospectively monitors real-world icatibant safety/tolerability and treatment outcomes.

RESULTS:

By July 2016, 58 patients from Israel and 594 patients from other countries were enrolled. Median age at diagnosis (16.7 vs. 21.3 years, P = 0.036) and median delay between symptom onset and diagnosis (0.8 vs. 6.6 years, P = 0.025) were lower in Israel compared with other countries, respectively. Differences in attack severity were not significant (P = 0.156); however, during follow-up, Israeli patients were less likely to miss > 7 days of work/school due to C1-INH-HAE-related complications (P = 0.007). A trend was also shown in Israel for earlier time to treatment (median 0.5 vs. 1.3 hours, P = 0.076), attack duration was shorter (median 5.0 vs. 9.0 hours, P = 0.026), and patients more often self-administered icatibant (97.2% vs. 87.5%, P = 0.003), respectively. However, Israeli patients were less likely to treat attacks (P = 0.036). Whereas patients in Israel reported exclusive use of danazol for long-term prophylaxis, those in other countries used various agents, including C1-INH.

CONCLUSIONS:

Recognition of C1-INH-HAE and timeliness of icatibant treatment appear more favorable, and attack duration shorter, in Israel compared with other countries.

• Authors: Elias Toubi, Shmuel Kivity, Yael Graif, Avner Reshef, Jaco Botha, Irmgard Andresen
• Journal: The Israel Medical Association journal : IMAJ (Isr Med Assoc J) Vol. 20 Issue 4 Pg. 227-232 (Apr 2018) ISSN: 1565-1088 [Print] Israel
• PMID: 29629730 (Publication Type: Journal Article, Observational Study)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• icatibant
• Danazol
• Bradykinin

Topics

• Adult
• Aged
• Aged, 80 and over
• Angioedemas, Hereditary (diagnosis, drug therapy, physiopathology)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects, therapeutic use)
• Bradykinin (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Danazol (administration & dosage)
• Delayed Diagnosis
• Female
• Follow-Up Studies
• Humans
• Israel
• Male
• Middle Aged
• Prospective Studies
• Registries
• Self Administration (statistics & numerical data)
• Severity of Illness Index
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome
• Young Adult