Jonathan A. Bernstein, MD, discusses the goals of HAE management, emphasizing early treatment of attacks and preventive therapy for patients with frequent, severe, or strategically located attacks.
Transcript
The core goals are to prevent episodes of swelling, to make it so patients have a normal life. So there’s a lot of stress and anxiety about when these events come on. Oftentimes, patients have a prodrome.
They can tell, like they have a characteristic rash called erythema marginata. Or they may have queasiness in their stomach or extreme fatigue. There’s a lot of signals that could indicate an ensuing attack. But not everybody has these prodromal symptoms.
So if they can identify when they’re having an attack, treat early, so the attack will resolve sooner. And if they treat late in the attack, and then it really is a half-life of bradykinin. And you’ve got to wait for that to resolve for these things to improve. So better to recognize the attack. Treat as early as possible so that it will resolve soon.
But if people are having frequent attacks, or if they’re having attacks of their throat or having a lot of gastrointestinal tract. So it’s not just frequency, it’s also location and severity, then it may be necessary to put them on a preventive therapy that will prevent these attacks from occurring, and just have the on-demand therapy readily available should there be a breakthrough attack.
