Angioedema Treatment Plan
Angioedema Center physicians work closely with patients to develop comprehensive management plans for their disease. These management plans focus on patient education, optimizing medications, and monitoring of efficacy and safety. The physicians will work with referring or local doctors to assure good continuity of care. Center nurses are skilled in patient care, patient education, and teaching therapy self-administration
Angioedema Center physicians utilize the full range of available medications to develop individualized treatment programs customized for your particular type of angioedema, needs, and preferences.
Dedicated physicians and scientists work side by side at the Angioedema Center to unlock the mysteries of every type of swelling and discover new treatments and cures. Additional new treatments will be used as they are developed.
The types of FDA-approved medications used are briefly described below (in alphabetical order):
- Anabolic androgens such as danazol, oxandrolone and stanozolol have, historically, been the most commonly prescribed prophylactic HAE therapies. Anabolic androgens are taken orally. While anabolic steroids have been shown to be useful, they are often associated with side effects particularly as the dose is increased. Androgens may not be well-tolerated by many women. They are also contraindicated in children as well as pregnant or nursing women.
- Antifibrinolytics such as epsilon aminocaproic acid (amicar) and tranexemic acid (lysteda) are used for prophylaxis of some forms of angioedema. Antifibrinolytics are taken orally. Significant potential side effects include thrombosis, muscle pain and weakness, and GI intolerance.
- Antihistamines. Antihistamines are beneficial in histamine-mediated angioedema but do not have a role in the treatment of bradykinin-mediated angioedemas, such as HAE.
- Berinert® brand of C1 inhibitor. Berinert has been FDA-approved for treating acute HAE attacks in adolescents and adults. Berinert is delivered intravenously and is approved for home infusion. Berinert is prepared from normal human blood and there is a remote risk of viral contamination.
- Cinryze® brand of C1 inhibitor concentrate. Cinryze has been FDA-approved for preventing HAE attacks in adolescents and adults. Cinryze is delivered intravenously and is approved for home infusion. Cinryze is prepared from normal human blood and there is a remote risk of viral contamination.
- Firazyr® brand of icatibant (a bradykinin receptor antagonist). Firazyr has been FDA-approved for treating acute HAE attacks in patients l8 years of age and older. Firazyr is delivered by subcutaneous injection and is approved for self-administration. Firazyr is a synthetic drug and is often associated with temporary pain and swelling at the injection site
- Kalbitor® brand of ecallantide (a plasma kallikrein inhibitor). Kalbitor has been FDA-approved for treating acute HAE attacks in patients 16 years of age or older. Kalbitor is delivered subcutaneously and must be administered by medical personnel. Kalbitor is produced in the laboratory and is free from risk virus contamination from blood. There is a small risk of allergic reactions to Kalbitor.
- Ruconest® brand of C1-inhibitor [recombinant] has been FDA-approved for treating acute HAE attacks in adults and adolescents. Ruconest® is delivered intravenously and is approved for self-administration. Ruconest is a purified human protein produced in genetically-modified rabbits and may cause allergic reactions in people with documented rabbit allergy.
- Progesterones. Progesterones may have beneficial effects to reduce swelling in women with bradykinin-mediated angioedema.
Note: The medical literature and practitioner experience confirm that corticosteroids (prednisone), antihistamines and epinephrine are not effective in treating angioedema caused by C1-inhibitor deficiency.