RESULTS: Four adult patient cases from the same family who underwent transitions in HAE prophylaxis are presented. Three were female and one male. Two patients who transitioned to berotralstat were initially prescribed attenuated androgens. Two patients were not taking LTP at the time of initiating targeted treatment but had previously been prescribed tranexamic acid. The length of transition varied between the patients, with the longest time taken to stabilize on new therapy being 26 months. All patients received regular follow-up in person or by telephone and all four required an adjustment from their initial treatment plan.
CONCLUSIONS: Transitioning between LTP in HAE may help improve control of attacks, avoid unwanted adverse effects, or better cater to individual patient preferences. Newer targeted therapies have been shown to be effective and should be discussed with patients. Shared decision-making is a tool that can aid these discussions. The transition journey between LTP therapies in HAE may not be straightforward and is specific to each patient. Physicians should consider complicating factors such as patient anxieties around changing treatment, adverse effects, preferred routes of administration, and speed of transition. Following patients closely during the transition period helps identify any issues, including difficulties with treatment adherence, and may allow the transition plan to be adapted when necessary.
结果:介绍了来自同一家庭的4例经历了HAE预防过渡的成年患者病例。三个是女性,一个是男性。两名过渡到berotralstat的患者最初服用了减毒雄激素。两名患者在开始靶向治疗时没有服用LTP,但之前已经服用了氨甲环酸。患者之间的过渡长度不同,新疗法稳定所需的最长时间为26个月。所有患者都亲自或通过电话接受了定期随访,所有四名患者都需要对其初始治疗计划进行调整。
结论:HAE中LTP之间的转换可能有助于改善对发作的控制,避免不必要的不良影响,或更好地满足个人患者的喜好。较新的靶向治疗已被证明是有效的,应与患者讨论。共享决策是可以帮助这些讨论的工具。HAE中LTP疗法之间的过渡过程可能并不简单,并且对每个患者都是特定的。医生应该考虑复杂的因素,如患者对改变治疗的焦虑,不利影响,首选的给药途径,过渡的速度。在过渡期密切关注患者有助于识别任何问题,包括治疗依从性困难,并可能允许在必要时调整过渡计划。