Aralast: a new alpha1-protease inhibitor for treatment of alpha-antitrypsin deficiency.
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.
Louie
Stan Gee
SG
Department of Pharmacy, University of Southern California, Los Angeles, CA 90089-9121, USA. slouie@usc.edu
Sclar
David Alexander
DA
Gill
Mark Anthony
MA
D006801:Humans; D000515:alpha 1-Antitrypsin / Q000191:economics / Q000627:therapeutic use*; D019896:alpha 1-Antitrypsin Deficiency / Q000188:drug therapy*
D000515:alpha 1-Antitrypsin