Self-administered therapy potentially allows patients to gain greater control over their attacks, resulting in a reduction in healthcare utilization” Mühlberg et al (2016).
BACKGROUND: Hereditary angio-oedema (HAE), C1 inhibitor HAE (C1-INH-HAE) type I and C1-INH-HAE type II, are inherited disorders characterised by potentially life-threatening recurrent swellings, caused by a deficiency of C1 inhibitor. Management includes attack treatment or prevention using prophylaxis/routine prevention.
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AIM: To evaluate the success of self-administration training as part of a home care programme for treatment of HAE using intravenous C1 inhibitor.
METHODS: In total, 18 patients (7 men, 11 women; aged 18-72 years) were trained to self-administer a plasma-derived C1 inhibitor concentrate for acute treatment or routine prevention of HAE attacks. The number of training sessions needed to learn intravenous self-administration, delay in time to treatment and reduction in attack frequency (per month) were evaluated after completion of the training.
RESULTS: All patients successfully completed training. The median number of training sessions required to be capable of unassisted/independent self-injection was 5 (range 2-30). Time to treatment was reduced from a median of 4.5 h (270 min) by medical professionals to 15 min by patients after self-administration training). Using the treatment as routine prevention resulted in a reduction of median frequency of attacks from 8 to 0.5 attacks/month.
CONCLUSION: C1 inhibitor self-administration for the treatment of HAE allows patients to quickly treat attacks at home, potentially reducing attack severity. The results also demonstrate the benefit of self-administered routine prevention therapy in a real-world patient population. Self-administered therapy potentially allows patients to gain greater control over their attacks, resulting in a reduction in healthcare utilization.
Mühlberg, H., Ettl, N. and Magerl, M. (2016) An analysis of the teaching of intravenous self-administration in patients with hereditary angio-oedema. Clinical and Experimental Dermatology. February 6th. [Epub ahead of print]
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