Session 4: Practical management – current angioedema treatments

There were two presenters on stage for the first talk in this session: Dr Priya Bowry from the Allergy Clinic, Upperhill Medical Centre, Kenya, and Prof Philip Li from the University of Hong Kong. Their presentation was titled “A Tale of Two Cities,” and their focus was on their real-life experience of managing HAE and advocating to make a difference. They delivered an interactive session on a case vignette, covering clinical investigations, management, and family screening, while contrasting the available laboratory tests and treatments in Hong Kong and Kenya.

Following this presentation, a panel of expert–Dr Ankur Jindal (India), Dr Solange Olivera Valle (Brazil), Rachel Annals (HAEi, United Kingdom), Dr Stefan Cimbollek (Spain), Prof Henriette Farkas (Hungary), Dr Andrea Zanichelli (Italy), Dr Jugurtha Rami (Algeria)–sat down for a roundtable, facilitated by Professor Danny Cohn from Amsterdam UMC in the Netherlands. The panel discussed managing HAE, especially in more resource-constrained parts of the world.

Virtual body mapping in pediatric hereditary angioedema

In a change to the published agenda, and in circumstances beyond the control of the originally advertised oral abstract presenter Dr Mauro Cancian of Azienda Ospedale Università di Padova, Italy, the first oral abstract in this session focused on the use of virtual body mapping in children with HAE, presented by Christine Selva from the US HAEA. She highlighted that while HAE has a significant impact on pediatric patients, personal experience is lightly understood, and new methods are needed to capture how children perceive and cope with their HAE. This research, therefore, aimed to understand the range of physical and psychological effects on children with HAE. The responses from children allowed the research team to understand that HAE is not central to how children define themselves, and that visualizing pain, fear, and frustration helped children to express the complex burden of the condition. In conclusion, Ms Selva said that virtual body mapping enabled a more nuanced understanding of pediatric HAE and can help healthcare professionals address the emotional and social needs of children with the condition.

Real-world evidence on healthcare resource utilization in patients treated with lanadelumab: Learnings from the French national SNDS database

Professor Laurence Bouillet from Grenoble Alpes University Hospital in France presented data on the impact of lanadelumab use on wider healthcare costs. She and fellow researchers used French health insurance data on treatment costs, as well as on patients’ need to go to the emergency room or spend time in the hospital. Their data indicated that there was a significant reduction in emergency hospitalizations in patients taking lanadelumab to prevent HAE attacks, and that overall, there was a significant reduction in total costs once patients started taking lanadelumab.

Canadian physicians’ use of long-term prophylaxis for hereditary angioedema in a pediatric population

Dr Natasha Correa from the University of Toronto, Canada, outlined that there is little knowledge of how HAE management in Canada has changed since long-term prophylaxis medicines became available for children under the age of 12. She presented research aimed at understanding physicians’ prescribing practices for pediatric patients with HAE. Overall, around two-thirds of HAE treating physicians in Canada had patients under the age of 12, and just under half of these patients were on long-term prophylaxis. The most commonly used preventative treatment was subcutaneous plasma-derived C1 inhibitor, followed by lanadelumab, berotralstat, and IV plasma-derived C1 inhibitor. Dr Correas said the results suggested a preference for subcutaneous or oral options, even when this meant using an off-label treatment (not currently licensed for use in children).

Angioedema Jeopardy: Test your knowledge

The next session saw the return of the much-loved Angioedema Jeopardy quiz session. Donning his best game-show host jacket, Professor Marc Riedl took charge of proceedings, aided by an expert panel, with the audience split into two teams: The Bradykinin Bunch and the Histamine Machine. Each team took it in turns to answer true or false questions of varying difficulty across six topics:

• Diagnosis
• Management
• Treatment
• Special populations
• Future medicine
• ACARE

After a lot of head scratching and some very tricky (and one or two ‘trick’) questions, the eventual winners were the Bradykinin Bunch, only nudging ahead in the closing rounds.