Lanadelumab in Hereditary Angioedema: Extending Dose Intervals from Every 2 Weeks to Every 4 Weeks

Both clinical trial and real-world data demonstrate the effectiveness of lanadelumab long-term prophylaxis (LTP) to prevent hereditary angioedema (HAE) attacks, which may be maintained after dose interval extension from every 2 weeks (Q2W) to every 4 weeks (Q4W) in patients with well-controlled disease (attack free for >6 months). This narrative review summarizes published data on lanadelumab treatment patterns collected from clinical trials and observational studies since US approval in 2018. Disease activity and HAE-related healthcare resource use at baseline and during the first 6 months of lanadelumab treatment may be useful indicators of patients with well-controlled disease who will be eligible for, and may derive benefit from, dose interval extension on lanadelumab. Patients who receive a dose interval extension could benefit from a reduction in treatment burden, but not all patients may be a good fit for interval extension. Although there are inherent limitations related to analyzing small sample sizes for sub-groups of patients with a rare disease and for data derived from real-world studies, these data can inform physicians and patients about the characteristics and outcomes of patients who have successfully extended dosing intervals of lanadelumab LTP. This may in turn encourage regular monitoring to facilitate optimization of treatment and outcomes for each patient.