Acute Management of Hereditary Angioedema Attacks

Several treatment modalities have become available for management of acute hereditary angioedema (HAE) attacks in the last 15 years. Most are now available to patients in North America, Europe, United Kingdom, and Australia, but few options exist in developing countries. Preferred contemporary use of the treatments to be discussed is "on demand," because control remains with the patient and delays in treatment access avoided. Four treatments-plasma-derived C1 inhibitor concentrate, recombinant C1 inhibitor concentrate, ecallantide, and icatibant-are reviewed in this article. All have been shown to be superior to placebo and effective in the management of all HAE attacks.