title: Aralast: a new alpha1-protease inhibitor for treatment of alpha-antitrypsin deficiency.
abstract: OBJECTIVE
  To review the epidemiology, pathogenesis, and management of patients with alpha-antitrypsin (AAT) deficiency syndrome and compare Aralast with Prolastin, 2 of the 3 available human plasma-derived AAT agents.
  
  
  METHODS
  Articles were identified using a MEDLINE (1966-September 2005) search with MESH headings that included alpha-antitrypsin and emphysema.
  
  
  METHODS
  All papers from peer-reviewed journals on the laboratory or clinical efficacy of plasma-derived AAT (eg, Prolastin, Aralast) for patients with this autosomal recessive disorder were reviewed.
  
  
  RESULTS
  Clinical trials found that AAT augmentation prevents progression of AAT-deficient emphysema and thus its associated morbidity and mortality. Treatment with Aralast has been shown to be safe and well tolerated, with a low incidence of mild to moderate adverse events. Pharmacoeconomics studies of AAT augmentation demonstrated that the use of Aralast was cost-effective as lifelong augmentation therapy for AAT-deficient emphysema.
  
  
  CONCLUSIONS
  Because of its effectiveness and extra safety measure compared with Prolastin, Aralast should be recommended for formulary inclusion.
authors.affiliation: Department of Pharmacy, University of Southern California, Los Angeles, CA 90089-9121, USA. slouie@usc.edu
authors.forename: Stan Gee
authors.initials: SG
authors.lastname: Louie
authors.forename: David Alexander
authors.initials: DA
authors.lastname: Sclar
authors.forename: Mark Anthony
authors.initials: MA
authors.lastname: Gill
mesh_terms: D006801:Humans; D000515:alpha 1-Antitrypsin / Q000191:economics / Q000627:therapeutic use*; D019896:alpha 1-Antitrypsin Deficiency / Q000188:drug therapy*
chemical_list: D000515:alpha 1-Antitrypsin