Evolution of Treatments for Hereditary Angioedema in Italy: Use of Lanadelumab in Clinical Practice

Introduction: Hereditary angioedema (HEA) is a rare genetic disorder characterised by recurrent episodes ofedema affecting various body districts. HEA therapy includes treatment of acute attacks and short- or long-termprophylaxis.Objective: To describe the main demographic and clinical characteristics of patients with HEA in real Italian clinicalpractice, as well as the use of pharmacological treatments, the use of healthcare resources and costs withparticular reference to lanadelumab.Methods: From administrative databases of healthcare institutions for about 9 million patients, between January2010 and September 2020, all-age HEA patients were identified through hospitalisation, exemption code or specificdrugs. Demographic and clinical characteristics, medications prescribed for acute attacks and prophylaxiswere described at inclusion. For patients treated with lanadelumab, the switching of dosing regimen from 2 to 4weeks was examined. Healthcare resource utilisation and costs were assessed at one-year follow-up.Results: 258 patients with HEA were identified (~0.003% of the sample). Of them, 41.1% were male, and themean age was 44.6 years; 80% of patients were treated for acute attacks, and 20% were on prophylaxis. Inlanadelumab-treated, 85% started treatment with a 2-week regimen, and of them 75.8% switched to a 4-weekregimen. For these patients, the estimated annual cost—calculated using the weighted average of patients whoswitched treatments—was €114,362.Conclusions: The data from this analysis on therapeutic management of HEA patients in the Italian clinical practiceshowed that, despite the limited number of patients treated with lanadelumab, many received one administrationevery 4 weeks, suggesting a good disease control.