Lanadelumab在老年II型遗传性血管性水肿患者中的成功应用

Maj Tasha Hellu, Maj Samuel Weiss, Derek Smith
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摘要

背景:II型遗传性血管性水肿(HAE)是一种罕见的遗传性疾病,其特征是全身反复出现皮下和/或粘膜下水肿,发病率和死亡率很高。Lanadelumab是一种新的、长期的HAE预防性治疗方案,已被证明是一种有效的治疗方案。然而,II型HAE患者或年龄≥65岁患者的数据有限。我们报告了一例用lanadelumab治疗的HAE患者,该患者的代表性不足。病例介绍:一名81岁男性患者在75岁时被诊断为II型HAE。最初,他描述自己每周都有腹痛发作,可能持续数天。77岁时,他开始按需接受icatibant治疗,以减轻疼痛。然而,在发作频率增加后,患者开始接受每2周300 mg皮下注射的lanadelumab。他从每月2到3次按需治疗变成6个月一次。结论:长期预防对于治疗HAE患者至关重要,但II型HAE患者和年龄≥65岁的数据有限。我们的病例支持在这些人群中使用lanadelumab。
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Successful Use of Lanadelumab in an Older Patient With Type II Hereditary Angioedema.

Background: Type II hereditary angioedema (HAE) is a rare, genetic disorder characterized by recurring subcutaneous and/or submucosal edema throughout the body and causes significant morbidity and mortality. Lanadelumab is a novel, long-term prophylactic treatment option for HAE and has proven to be an effective treatment option. However, data are limited in patients with type II HAE or aged ≥ 65 years. We present a case of HAE treated with lanadelumab in a patient of an underrepresented population.

Case presentation: An 81-year-old male patient was diagnosed with type II HAE at the age of 75 years. Initially, he described having attacks of abdominal pain weekly that could last up to several days. At age 77 years, he began an on-demand treatment, icatibant, which diminished pain. However, after increasing frequency of attacks, the patient started receiving lanadelumab 300 mg subcutaneously every 2 weeks. He went from requiring on-demand treatment 2 to 3 times per month to once in 6 months.

Conclusions: Long-term prophylaxis is critical for managing HAE patients, but data are limited for patients with type II HAE and aged ≥ 65 years. Our case supports the use of lanadelumab in these populations.

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