Keynote lecture 2

In the second series of keynote lectures, each speaker focused on a single topic, offering a 360-degree view.

This house believes in the DANCE classification

Professor Avner Reshef from the Barzilai University Medical Center in Israel spoke about the rationale of the DANCE classification of angioedema, which aimed to establish an up-to-date global consensus on the definition, acronyms, nomenclature, and classification of angioedema. Prof Reshef described the process to establish DANCE and its publication in August 2024, while also paying tribute to the late Professor Marcus Maurer. He also acknowledged issues with the classification and noted that some experts have advised on an alternative classification system.

This house believes that anabolic androgens still have a role to play in the treatment of HAE

Professor Bruce Zuraw took his turn to address the topic of steroid use in HAE. Starting with a case in which he used androgens to treat a patient, Dr Zuraw suggested that the best treatment depends on the treatment options available at the time. The patient case study he recounted was from 1983, when no other treatment options existed for HAE. Right now, he suggested, he never uses anabolic androgens, but that not everyone is so lucky as to have access to HAE-specific medications, and as a result, androgens are much better than nothing.

Practically, he advised that targeted modern therapy is strongly preferred over the use of anabolic androgens. But when it is not available, the lowest effective dose of steroids can be used. Care should be taken when giving androgens to children, and they should not be prescribed in pregnancy. Ultimately, he counselled, we must all work towards universal availability of targeted therapy.