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| |  C1-Esterase Inhibitor Offers Fast Relief of Acute Laryngeal and Peripheral Attacks in Patients With HAE: Presented at EAACI By Sara Freeman LONDON -- June 10, 2010 -- A single, 20 U/kg intravenous dose of a human C1-esterase inhibitor (C1-1NH) is a rapid and well-tolerated way to relieve the symptoms of both acute laryngeal and peripheral attacks in patients with hereditary angio-oedema (HAE), researchers said here at the 29th Congress of the European Academy of Allergy and Clinical Immunology (EAACI). Data from the ongoing, open-label International Multicentre Prospective Angioedema C1-inhibitor Trial (IMPACT 2) show that the novel therapy can provide relief of laryngeal attacks within 15 minutes and peripheral attacks within 31 minutes. "Angio-oedema is pretty common, but it is usually histamine-induced," said Timothy Craig, DO, Pennsylvania State University, Hershey, Pennsylvania, on June 7. "In contrast, HAE is primarily induced by bradykinin, and so the drugs traditionally used to treat angio-oedema do not usually work for HAE." IMPACT 2 was open-label extension of the IMPACT 1 trial in which patients with a history of acute moderate to severe facial or abdominal attacks were randomised to treatment with C1-1NH or placebo. For the assessment of laryngeal attacks, it was not considered ethical to run a placebo-controlled investigation, Dr. Craig said. He reported data on 16 patients who had participated in the preceding IMPACT trial. A total of 39 laryngeal attacks were reported, of which 11 were mild, 16 were moderate, and 12 were severe. The number of attacks per patient varied from 1 to 8, with 7 patients being treated for >1 attack. The median time from the estimated start of the attack to the start of treatment was 3.8 hours, with the onset of symptomatic relief observed within 15 minutes and complete resolution of symptoms in just over 5 to 8 hours. Only 2 patients experienced adverse events, 1 of which was a repeat laryngeal attack more than 2 days after C1-INH treatment and designated unrelated to treatment. Robyn Levy, MD, Family Allergy and Asthma Center, Atlanta, Georgia, reported other findings from the IMPACT 2 trial on the use of C1-INH in the treatment of peripheral oedema. A total of 214 peripheral attacks (32% mild, 62% moderate, and 6% severe) were reported in 29 patients. The mean number of peripheral attacks treated per patient was 8.7, and the median time from the estimated start of the attack to receipt of treatment was 6 hours. Patients began to experience relief within 31 minutes, with complete symptomatic resolution within 23 to 24 hours. "The safety analysis revealed no signals of concern," Dr. Levy observed. Funding for this study was provided by CSL Behring GmBH. [Presentation titles: A Prospective Study of Rapid Relief Provided by C1 Esterase Inhibitor in Emergency Treatment of Acute Laryngeal Attacks in Hereditary Angioedema. Abstract 1204; AND A Prospective Study of the Benefit of C1 Esterase Inhibitor Therapy for Treating Acute Peripheral Hereditary Angioedema Attacks. Abstract 1206]
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