title: Current state of hereditary angioedema management: a patient survey.
abstract: Hereditary angioedema (HAE) is a chronic disease with a high burden of disease that is poorly understood and often misdiagnosed. Availability of treatments, including C1 esterase inhibitor (C1INH) replacement, ecallantide, and icatibant, marks a significant advance for HAE patients. We aimed to better understand the current state of HAE care, from a patient perspective, after the introduction of several novel therapies. One session of the United States Hereditary Angioedema Association 2013 patient summit was devoted to data collection for this study. Patients attending the summit were self-selected, and HAE diagnosis was self-reported. Survey questions assessed patient characteristics, burden of disease, and treatment. Participant responses were captured using an audience response system. We surveyed 149 (80%) type I and II HAE (HAE-C1INH) and 37 (20%) HAE with normal C1INH (HAE-nlC1INH) patients. HAE-C1INH (72%) and HAE-nlCINH patients (76%) equally reported that HAE had a significant impact on quality of life (QOL). A third of HAE-C1INH patients were diagnosed within one year of their first HAE attack, but another third reported a delay of more than 10 years. Most HAE-C1INH (88%) and HAE-nlC1INH (76%) patients had on-demand treatment available. HAE-C1INH patients frequently had an individual treatment plan (76%) compared with 50% of HAE-nlC1INH patients. Most HAE-C1INH patients went to the emergency department (ED) or were hospitalized less than once every six months (80%). Our findings show that HAE management is improving with good access to on-demand and prophylactic treatment options. However, HAE patients still have a significant burden of disease and continued research and educational efforts are needed.
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Aleena
authors.initials: A
authors.lastname: Banerji
authors.forename: Paula
authors.initials: P
authors.lastname: Busse
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Christiansen
authors.forename: Henry
authors.initials: H
authors.lastname: Li
authors.forename: William
authors.initials: W
authors.lastname: Lumry
authors.forename: Mark
authors.initials: M
authors.lastname: Davis-Lorton
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Bernstein
authors.forename: Michael
authors.initials: M
authors.lastname: Frank
authors.forename: Anthony
authors.initials: A
authors.lastname: Castaldo
authors.forename: Janet F
authors.initials: JF
authors.lastname: Long
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Zuraw
authors.forename: Marc
authors.initials: M
authors.lastname: Riedl
mesh_terms: D000293:Adolescent; D000328:Adult; D054179:Angioedemas, Hereditary / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D019468:Disease Management; D018450:Disease Progression; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012008:Recurrence; D011795:Surveys and Questionnaires; D055815:Young Adult