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Comorbidities in Canadian patients with hereditary angioedema: a quantitative survey study
Paul K Keith1, Gina Lacuesta2, Dawn Goodyear3
1Department of Medicine, McMaster University, 3V47 HSC 1280 Main St W, Hamilton, ON, L8S 4K1, Canada. keithp@mcmaster.ca.
Insights
Hereditary angioedema (HAE) patients show higher rates of autoimmune conditions, allergies, and asthma compared to the general population. This highlights the need for increased awareness of these comorbidities in HAE management.
Area of Science:
- Immunology
- Genetics
- Epidemiology
Background:
- Hereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent swelling attacks.
- The association between HAE and other comorbidities, particularly in relation to HAE treatments, requires further investigation.
- Understanding comorbidity prevalence in HAE patients is crucial for comprehensive patient care.
Purpose of the Study:
- To identify and quantify the prevalence of comorbidities in patients with HAE.
- To compare the prevalence of these comorbidities in HAE patients against the general Canadian population.
- To assess the impact of HAE on the development of associated health conditions.
Main Methods:
- A quantitative survey was conducted using a self-administered, anonymous online questionnaire.
- Data was collected from October 13, 2022, to January 11, 2023.
- Participants were individuals diagnosed with HAE and enrolled in the CSL Behring PLUS+ patient support program.
Main Results:
- The study included 123 HAE patients, with 85% on long-term prophylaxis.
- A significant increase in autoimmune conditions (31% vs. 5-8%), allergies (54% vs. 27%), and asthma (17% vs. 8-11%) was reported compared to the general population.
- Commonly reported autoimmune conditions included psoriasis, rheumatoid arthritis, and inflammatory bowel disease.
Conclusions:
- HAE patients, particularly those on prophylaxis, exhibit a higher prevalence of specific comorbidities.
- Healthcare providers should maintain a high index of suspicion for autoimmune conditions, allergies, and asthma in HAE patients.
- Early identification and management of comorbidities can improve the overall health outcomes for individuals with HAE.
Background:
Evidence linking hereditary angioedema (HAE) to the potential association of developing other comorbidities, and how it is affected by HAE treatment is needed. The objective of this study is to identify comorbidities and measure the prevalence in HAE patients, compared to the prevalence in the general population using multiple Canadian sources when available.
Methods:
A quantitative survey design via a self-administered anonymous online questionnaire was conducted from October 13, 2022, to January 11, 2023. Respondents were individuals with HAE, enrolled in the CSL Behring patient support program (CSL Behring PLUS+; PSP).
Results:
This study included 123 patients (81% female; 60% HAE-1/HAE-2, 24% HAE Normal C1-INH (nC1-INH), 16% unsure of HAE type; 85% of patients were on long-term prophylaxis plus on-demand). Patients reported using the following HAE treatments: C1-esterase inhibitor (subcutaneous or intravenous), lanadelumab, icatibant, danazol, and tranexamic acid. Respondents (69%) reported at least one: autoimmune condition, asthma, or allergy. Reported autoimmune conditions (psoriasis, rheumatoid arthritis, inflammatory bowel disease, chronic urticaria, lupus, and psoriatic arthritis) were much higher than the general population (31% versus 5-8%). Patient-reported allergies were two times higher than the general population (54% versus 27%; i.e., aeroallergens) and asthma rates nearly two times higher than the general population (17% versus 8-11%).
Conclusion:
This cohort of HAE patients, most of whom were on prophylaxis, reported an increased prevalence of certain comorbidities compared to the general Canadian population. Healthcare professionals should be aware of the potentially increased risk of autoimmune conditions, allergies, and asthma in patients with HAE.
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