Fewer HAE attacks evident with use of Takhzyro in Canadian study

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Using Takhzyro (lanadelumab) for at least six months resulted in a decrease in hereditary angioedema (HAE) attacks and treated attacks, according to a Canadian case review study.

Three of her 12 patients went into complete remission and all enjoyed more comfortable social lives, investigators noted.

The study, carried out by researchers from several Canadian institutions, is entitled “Impact of lanadelumab in hereditary angioedema: a case series of 12 patients in Canada, ”And published in the journal Allergy, asthma and clinical immunology.

Takhzyro is approved for the long-term prevention of attacks in people with HAE types 1 and 2. It counteracts the swelling typically seen during these attacks by preventing an enzyme called kallikrein from releasing bradykinin, an inflammatory molecule that , in large amounts, triggers swelling by increasing blood vessel permeability or leakage.

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Although the drug has reduced seizures and improved various measures of quality of life in patients participating in several clinical trials, there do not appear to be any reports detailing its effects in HAE patients in Canada.

Researchers at St. Michael’s Hospital in Toronto, the University of British Columbia in Vancouver, and Dalhousie University in Halifax reviewed available medical records of HAE patients receiving long-term prophylactic or preventative treatment. with Takhzyro in these three establishments.

They identified a total of 12 patients using Takhzyro for at least six months. Their average age was 43, with an average of eight years between onset of HAE symptoms and diagnosis.

Most of them – 10 out of 12 patients – were on long-term preventive treatment with plasma-derived C1 inhibitors (pdC1-INH), administered intravenously or subcutaneously (subcutaneous injection), before start treatment with Takhzyro. The other two had never used long-term prophylactic agents before Takhzyro.

All but one of the individuals received 300 mg of Takhzyro, administered subcutaneously, every two weeks. The treatment regimen for this person was changed from every two weeks to every four weeks, due to the lack of attack for six months.

Once patients started treatment with Takhzyro, average overall attack rates fell 72%, while treated attack rates decreased by 62%. More specifically, the median number of annual HAE attacks fell from 11 to three, and that of treated attacks from six to two. Three patients remained seizure-free after starting treatment with Takhzyro.

While three patients reported losing days of work due to HAE in the year before starting treatment with Takhzyro, only one remained on sick leave due to HAE afterward.

Finally, eight of the 12 patients reported that HAE did not affect their social outings after starting treatment with Takhzyro.

“Our case series shows that [long-term prophylaxis] with [Takhzyro] resulted in dramatic reductions in HAE attack rates in all patients included in the study, ”the investigators wrote.

They noted that in their study, the effectiveness of Takhzyro appeared to be lower than that seen in the phase 3 HELP trial (NCT02586805), although they noted that the two studies are not directly comparable. They argued that this difference in efficacy could be explained by the “heavy use” of pdC1-INH by Canadian patients. This, they reported, could mean that Canadian patients were in better overall health at the start of the case study, making the difference in results before and after treatment with Takhzyro appear smaller.

“The results of our case series support the 2019 International / Canadian HAE Guideline which [Takhzyro] is an effective therapy for long-term prophylaxis, ”they wrote. “In our patient population, the initiation of [Takhzyro] better disease control, reduced treatment burden and better impact of HAE on social outings.


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