Adverse effects of danazol prophylaxis on the lipid profiles of patients with hereditary angioedema.
BACKGROUND
Hereditary angioedema (HAE) is a rare disorder caused by the deficiency of the C1-inhibitor gene (C1INH) . Patients experience recurrent bouts of edema, which can occur in almost any region of the body. As regards the treatment of the disease, danazol (an attenuated androgen) is used, among other agents, for long-term prophylaxis.


OBJECTIVE
The aim of this study was to investigate the possible adverse effects of danazol on serum lipid profile, as well as to ascertain whether danazol treatment is associated with an increased risk of atherosclerosis.


METHODS
Serum concentrations of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, apolipoprotein A-I, apolipoprotein B-100, and lipoprotein(a) were compared between danazol-treated patients with HAE and 2 control groups (ie, patients who did not receive long-term danazol prophylaxis and untreated healthy subjects).


RESULTS
Serum concentrations of HDL ( P = .0002 and P < .0001) and apolipoprotein A-I ( P = .0015 and P < .0001) were significantly lower, whereas LDL ( P = .0129 and P = .0127) and apolipoprotein B-100 ( P = .0456 and P = .0013) were higher in the danazol-treated patients compared with the 2 control groups, respectively. No significant difference was found in total cholesterol, triglyceride, or lipoprotein(a) levels. Patients who received danazol had an 11.6 (95% CI, 2.7-49.7) times higher risk for abnormally low HDL levels and a 4.4 (95% CI, 1.2-16.0) times lower risk for high LDL concentrations.


CONCLUSIONS
Our findings indicate that the long-term use of danazol is associated with an increased risk for early atherosclerosis in patients with HAE. Consequently, monitoring of HDL and LDL levels at regular intervals is recommended during follow-up.
Széplaki
Gábor
G
Third Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Kútvölgyi ut 4, H-1125 Budapest, Hungary.
Varga
Lilian
L
Valentin
Szilvia
S
Kleiber
Mónika
M
Karádi
István
I
Romics
László
L
Füst
George
G
Farkas
Henriette
H
D000328:Adult; D000799:Angioedema / Q000097:blood / Q000517:prevention & control*; D001161:Arteriosclerosis / Q000139:chemically induced*; D003613:Danazol / Q000009:adverse effects*; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged
D004965:Estrogen Antagonists; D008055:Lipids; D003613:Danazol