Bridging the Conversation: Redosing in HAE

In our final episode, hereditary angioedema (HAE) treatment redosing takes center stage during a discussion with Dr. John Anderson, clinical assistant professor at The University of Alabama at Birmingham and partner at AllerVie Health, and Dr. Raffi Tachdjian, associate clinical professor at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Drs. Anderson and Tachdjian will define redosing and explore misconceptions about redosing with acute HAE treatments. They will also discuss approaches to engage patients to help identify occurrences of redosing and management considerations for patients who consistently redose during HAE attacks. Finally, Drs. Anderson and Tachdjian will share clinical data related to redosing rates for RUCONEST® (C1 esterase inhibitor [recombinant]). 

WHAT IS RUCONEST? 

RUCONEST® (C1 esterase inhibitor[recombinant]) is indicated for the treatment of acute attacks in adult and adolescent patients with hereditary angioedema (HAE). Effectiveness in clinical studies was not established in HAE patients with laryngeal attacks. 

IMPORTANT SAFETY INFORMATION 

RUCONEST is contraindicated in patients with a history of allergy to rabbits or rabbit-derived products and for patients with a history of life-threatening immediate hypersensitivity reactions, including anaphylaxis, to C1 esterase inhibitor (C1-INH) preparations.  

Monitor patients for early signs of allergic or hypersensitivity reactions (including hives, generalized urticaria, tightness of the chest, wheezing, hypotension, and/or anaphylaxis). If symptoms occur, discontinue RUCONEST and administer appropriate treatment.  

Serious arterial and venous thromboembolic (TE) events have been reported with plasma-derived C1-INH products. Risk factors may include the presence of an indwelling venous catheter/access device, prior history of thrombosis, underlying atherosclerosis, use of oral contraceptives or certain androgens, morbid obesity, and immobility. Monitor patients with known risk factors for TE events during and after RUCONEST administration.   

Appropriately trained patients may self-administer RUCONEST upon recognition of an HAE attack. Advise patients to seek medical attention if progress of any attack makes them unable to properly prepare or administer a dose of RUCONEST. No more than 2 doses should be administered within a 24-hour period.  

The serious adverse reaction reported in clinical trials was anaphylaxis. The most common adverse reactions (incidence ≥2%) were headache, nausea, and diarrhea.  

Before prescribing RUCONEST, please read the full Prescribing Information including the Patient Product Information. 

DISCLAIMER 

This educational program is sponsored by Pharming Healthcare, Inc. The speakers have been compensated for the presentation of this information. The information contained within this podcast is for educational purposes only and is not intended to be medical advice. Patient experiences may be discussed in this episode. It is important to recognize that these experiences may not be representative, as every patient has a unique disease course. This activity is not intended for Continuing Medical Education credits.  

EPISODE REFERENCE LIST 

1. Maurer M, Magerl M, Betschel S, et al. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update. Allergy. 2022;77(7):1961-1990. doi:10.1111/all.15214 
2. Busse PJ, Christiansen SC, Riedl MA, et al. US HAEA Medical Advisory Board 2020 guidelines for the management of hereditary angioedema. J Allergy Clin Immunol Pract. 2021;9(1):132-150.e3. doi:10.1016/j.jaip.2020.08.046
3. Bernstein JA, Tyson C, Relan A, et al. Modeling cost-effectiveness of on-demand treatment for hereditary angioedema attacks. J Manag Care Spec Pharm. 2020;26(2):203-210. doi:10.18553/jmcp.2019.19217
4. Magerl M, Zampeli V, Buttgereit T, Maurer M. Observations on real-world on-demand therapy use and outcome in patients with HAE due to C1-INH deficiency. Poster presented at: 4th Global Urticaria Forum; December 5-6, 2018; Berlin, Germany.
5. Balla Z, Ignácz B, Varga L, Kőhalmi KV, Farkas H. How Angioedema Quality of Life Questionnaire can help physicians in treating C1-inhibitor deficiency patients?. Clin Rev Allergy Immunol. 2021;61(1):50-59. doi:10.1007/s12016-021-08850-9
6. Ruconest. Prescribing information. Pharming Healthcare Inc; 2020.
7. Bernstein JA, Relan A, Harper JR, Riedl M. Sustained response of recombinant human C1 esterase inhibitor for acute treatment of hereditary angioedema attacks. Ann Allergy Asthma Immunol. 2017;118(4):452-455. doi:10.1016/j.anai.2017.01.029