Canadian Physician Survey on the Medical Management of Hereditary Angioedema

Publication date: Available online 26 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Lisa Fu, Amin Kanani, Gina Lacuesta, Susan Waserman, Stephen Betsche
BackgroundHereditary angioedema (HAE) is a rare disease that has significant morbidity and may be potentially fatal due to airway obstruction. Our study aimed to determine how Canadian physicians diagnose and treat HAE.ObjectiveTo determine practice patterns in physicians treating HAE.MethodsA survey was designed to determine HAE practice patterns amongst Canadian physicians. These physicians were identified by sending the survey to members of three physician organizations (Canadian Hereditary Angioedema Network, Canadian Society of Clinical Immunology and Allergy, Canadian Hematology Society).ResultsThirty-six physicians responded to the survey. Thirty-four physicians were included in the analysis. The majority of referrals to HAE treating physicians were from family and emergency room physicians. The most common sites of swelling reported by patients to physicians were facial, peripheral and abdominal. A mean of 53.9% of HAE-Type 1 and II patients and 53.4% of HAEnC1INH patients were on long term prophylaxis. A mean of 41.9%, 19.4% and 93.5% of respondents had some patients on danazol, tranexamic acid and C1-inhibitor respectively. The majority of physicians felt severity and frequency of attacks were the most important determinants in deciding when to use prophylaxis. A mean of 88.2% of physicians used C1-inhibitor to treat acute attacks and 79.4% used icatibant. All respondents were aware of HAE guidelines.ConclusionPhysicians are using guidelines to support their practice, and using agents suggested by guidelines with confidence. C1-inhibitor is being used widely for prophylaxis, as well as acute treatment of attacks along with icatibant. However certain special patient populations may require additional focus in future guidelines.



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