title: Use of a C1 Inhibitor Concentrate in Adults ≥65 Years of Age with Hereditary Angioedema: Findings from the International Berinert®(C1-INH) Registry.
abstract: Treatment of hereditary angioedema (HAE) in 'older adults' (those aged ≥65 years) has not been well studied. The international Berinert Patient Registry collected data on the use of intravenous plasma-derived, pasteurized, nanofiltered C1-inhibitor concentrate (pnfC1-INH; Berinert®/CSL Behring) in patients of any age, including many older adults.
  
  
  
  This observational registry, conducted from 2010 to 2014 at 30 US and seven European sites, gathered prospective (post-enrollment) and retrospective (pre-enrollment) usage and adverse event (AE) data on subjects treated with pnfC1-INH.
  
  
  
  The registry documented 1701 pnfC1-INH infusions in 27 older adults. A total of 1511 HAE attacks treated with pnfC1-INH administration were reported among 25 of the 27 (92.6 %) older adults. Among the older adults, mean (standard deviation [SD]) (8.8 [4.1] IU/kg) and median (6.4 IU/kg) pnfC1-INH doses were lower than those reported for 252 'younger adults' (those aged <65 years: 12.9 [6.2], 12.5 IU/kg, respectively). A total of 19 AEs occurred in 8 of 23 (34.8 %) older adults with prospective data, for rates of 0.83 events per subject and 0.02 events per infusion, similar to corresponding rates in younger adults (0.91 and 0.03, respectively). None of the AEs were considered related to pnfC1-INH, and all but two events (prostatectomy, gastrointestinal bleeding) were mild or moderate in severity. Administration of pnfC1-INH outside of a healthcare setting was reported for 1609 infusions in 16 older adults, representing 94.6 % of all pnfC1-INH infusions in this age group. There were no recorded instances of difficulty with self-administration of intravenous pnfC1-INH.
  
  
  
  These findings suggest a high degree of safety with intravenous pnfC1-INH use in older adults with HAE, regardless of administration setting. Trial Registration Clinicaltrials.gov NCT01108848.
authors.affiliation: HAE Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
authors.forename: Anette
authors.initials: A
authors.lastname: Bygum
authors.affiliation: Hemophilia Center Rhine Main, Mörfelden-Walldorf, Germany.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Martinez-Saguer
authors.affiliation: Klinikum rechts der Isar, Hals-Nasen-Ohren Klinik, Technische Universität München, Munich, Germany.
authors.forename: Murat
authors.initials: M
authors.lastname: Bas
authors.affiliation: Central Pennsylvania Asthma and Allergy Care, Altoona, PA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rosch
authors.affiliation: CSL Behring, 1020 First Ave, King of Prussia, PA, 19406, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Edelman
authors.affiliation: CSL Behring, 1020 First Ave, King of Prussia, PA, 19406, USA. mikhail.rojavin@cslbehring.com.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Rojavin
authors.affiliation: CSL Behring, 1020 First Ave, King of Prussia, PA, 19406, USA.
authors.forename: Debora
authors.initials: D
authors.lastname: Williams-Herman
mesh_terms: D000328:Adult; D000368:Aged; D054179:Angioedemas, Hereditary / Q000188:drug therapy* / Q000378:metabolism; D003174:Complement C1 Inactivator Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D050718:Complement C1 Inhibitor Protein; D005060:Europe; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D014481:United States
chemical_list: D003174:Complement C1 Inactivator Proteins; D050718:Complement C1 Inhibitor Protein; C469952:SERPING1 protein, human