Current and emerging biologics for the treatment of hereditary angioedema

Expert Opin Biol Ther. 2019 Jun;19(6):517-526. doi: 10.1080/14712598.2019.1595581. Epub 2019 Mar 26.

Abstract

Introduction: Hereditary angioedema due to C1-INH deficiency (C1-INH-HAE) is a rare disease with unpredictable, self-limiting and localized swelling episodes involving the cutaneous and subcutaneous tissues. In the last decade, the spectrum of the possibilities to control the disease has considerably changed with the development of biologic therapies making necessary a careful evaluation of the differences among current and emerging treatments to properly optimize the management of patients.

Areas covered: This review serves to summarize the literature regarding the use of biologics for the treatment of C1-INH-HAE. Medications already available on the market and new drugs in different phases of development are addressed.

Expert opinion: The advent of biologic therapies dramatically improved the lives of patients with C1-INH-HAE although further improvement is still needed. Whether this is cost/effective will be answered in the next years when we will see if these major advances will benefit the majority of the patients.

Keywords: Hereditary angioedema; biologics; chronic disease; clinical trial; rare diseases; treatment.

Publication types

  • Review

MeSH terms

  • Angioedemas, Hereditary / drug therapy*
  • Angioedemas, Hereditary / genetics
  • Antibodies, Monoclonal / therapeutic use
  • Biological Products / therapeutic use*
  • Bradykinin B2 Receptor Antagonists / therapeutic use
  • Complement C1 Inhibitor Protein / metabolism
  • Complement C1 Inhibitor Protein / therapeutic use
  • Factor XII / immunology
  • Genetic Therapy
  • Humans
  • Kallikreins / antagonists & inhibitors
  • Kallikreins / metabolism
  • Recombinant Proteins / biosynthesis
  • Recombinant Proteins / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Biological Products
  • Bradykinin B2 Receptor Antagonists
  • Complement C1 Inhibitor Protein
  • Recombinant Proteins
  • Factor XII
  • Kallikreins