Successful use of lanadelumab in an elderly patient with type II
hereditary angioedema
Abstract
Hereditary angioedema (HAE) is a rare genetic disorder characterized by
recurring episodes of subcutaneous and/or submucosal edema without
urticaria due to an excess of bradykinin (1, 2). HAE is classified into
2 main types (1). Type I HAE is caused by deficiency of C1 esterase
inhibitor, accounting for 85% of cases (1). Type II HAE occurs in only
15% of cases and is marked by normal to elevated levels of C1 esterase
inhibitor but with a reduction in activity (1). An angioedema attack can
range in severity depending on the location and degree of edema (2).
Furthermore, patients with HAE are often diagnosed with anxiety and
depression secondary to their poor quality of life (3). Thus, long-term
prophylaxis of attacks can be crucial to reduce the physical and
psychological implications. For long-term prophylaxis, lanadelumab, a
subcutaneously delivered monoclonal antibody inhibitor of plasma
kallikrein, has been proven to decrease the frequency of HAE attacks
without significant side effects (4). However, data is limited,
specifically regarding patients with type II HAE and patients
>/= 65 years (4).