Treatment with C1 inhibitor concentrate in abdominal pain attacks of patients with hereditary angioedema.
BACKGROUND
Abdominal edema attacks in patients with hereditary angioedema are often extremely painful, associated with vomiting and diarrhea, and have a high potential for causing recurrent disability of the patient.


METHODS
Intraindividual comparison of retrospective data in 75 hereditary angioedema patients comprising 4,834 abdominal attacks treated with C1 inhibitor concentrate versus 17,444 untreated abdominal attacks.


RESULTS
The mean duration of abdominal attacks was 92.0 hours (SD, 40.8 hr) when untreated compared to 39.9 hours (SD, 30.0 hr) when treated. Patients reported a mean maximal pain score of 8.6 (SD, 1.7; range, 1-10) for untreated attacks compared to 4.5 (SD, 2.9) when treated. Vomiting occurred in 83.3 percent of untreated attacks and in 6.0 percent of treated attacks, respectively. Diarrhea was reported in 41.8 percent of untreated attacks and in 11.0 percent of treated attacks, whereas cardiovascular collapse due to hypovolemia was observed in 3.5 percent of untreated attacks versus 0.1 percent in treated attacks. Mean time to relief of symptoms was 53.5 minutes when treated early compared to 114 minutes when treatment was delayed. No drug-related adverse or serious adverse events were observed as far as the injections were performed correctly.


CONCLUSIONS
C1 inhibitor concentrate is highly effective and safe in treating abdominal attacks in patients suffering from hereditary angioedema.
Bork
Konrad
K
Department of Dermatology, Johannes Gutenberg University, Mainz, Germany. bork@hautklinik.klinik.uni-mainz.de
Meng
Gabriele
G
Staubach
Petra
P
Hardt
Jochen
J
D015746:Abdominal Pain / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000799:Angioedema / Q000150:complications* / Q000235:genetics*; D001510:Bed Rest; D002648:Child; D002675:Child, Preschool; D003174:Complement C1 Inactivator Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D050718:Complement C1 Inhibitor Protein; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D020896:Hypovolemia / Q000150:complications; D007223:Infant; D007267:Injections; D017060:Patient Satisfaction; D012189:Retrospective Studies; D015843:Serpins / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014474:Unconsciousness / Q000188:drug therapy / Q000209:etiology; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology
D003174:Complement C1 Inactivator Proteins; D050718:Complement C1 Inhibitor Protein; C469952:SERPING1 protein, human; D015843:Serpins