Most patients with hereditary angioedema (HAE) have prodromal symptoms that signal an oncoming HAE attack giving the patients sufficient time to initiate treatment and decrease the morbidity associated with that attack, according to survey findings presented today at the 2009 American College of Allergy, Asthma & Immunology (ACAAI) Annual Meeting. Early recognition of symptoms such as fatigue and nausea, which occur frequently before an acute HAE attack, can provide patients with up to 24 hours to initiate treatment before further onset of the attack.
Administered in parallel with the ongoing, open label International Multi-center Prospective Angioedema C1-Inhibitor Trial (I.M.P.A.C.T. 2), the survey was designed to evaluate prodromal symptoms at the time of treatment of HAE attacks. Thirty-one patients experiencing 253 attacks were treated with C1 esterase inhibitor concentrate (C1-INH). Prodromal symptoms were reported before 171 of these attacks (67.6 percent). The start of symptoms ranged from 20 minutes to 24 hours before the onset of HAE exacerbations, with a median duration of 12 hours. The most commonly reported prodromal symptoms were fatigue (41.9%), nausea (26.1%) and flu-like feelings (22.1%). Other prodromal symptoms included urticaria-like skin eruptions (11.1%), non-itchy rash (11.1%), bowel movement change (9.1%), abdominal rumbling (7.5%), and tingling (4.0%).
"For patients suffering from HAE, timely treatment is critical to effective management of this debilitating and life-threatening disorder," said Timothy J. Craig, D.O., Professor of Medicine and Pediatrics at Penn State University in Hershey, PA., and one of the study's investigators. "Our study shows that patients who recognize the warning signs of an HAE attack have adequate time to initiate treatment and improve their outcomes."