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Ann Allergy Asthma Immunol. 2010 Jun;104(6):523-9. doi: 10.1016/j.anai.2010.04.012.

EDEMA4: a phase 3, double-blind study of subcutaneous ecallantide treatment for acute attacks of hereditary angioedema.

Author information

1
Family Allergy & Asthma Center PC, Atlanta, Georgia 30342, USA. levyr@familyallergycenter.com

Abstract

BACKGROUND:

Hereditary angioedema (HAE) is a genetic disorder resulting from low levels of C1-inhibitor activity that manifests as acute attacks of variable and sometimes life-threatening edema. Ecallantide is a novel potent inhibitor of human plasma kallikrein, a key mediator of the excessive formation of bradykinin associated with the signs and symptoms of an HAE attack.

OBJECTIVE:

To evaluate the efficacy and safety of ecallantide in the treatment of acute HAE attacks.

METHODS:

In this double-blind, placebo-controlled study, patients with a moderate to severe HAE attack were randomized 1:1 to receive 30 mg of subcutaneous ecallantide or placebo. The primary efficacy end point was change from baseline in mean symptom complex severity score 4 hours after dosing. Additional end points included treatment outcome score 4 hours after dosing and maintenance of significant overall improvement through 24 hours.

RESULTS:

Ninety-six patients were enrolled. Mean (SD) change from baseline in mean symptom complex severity score 4 hours after dosing was significantly greater with ecallantide use (-0.8 [0.6]) compared with placebo use (-0.4 [0.8]) (P = .01 comparing distributions). Ecallantide therapy was also associated with a significantly larger mean (SD) treatment outcome score 4 hours after dosing vs placebo use (ecallantide: 53.4 [49.7]; placebo: 8.1 [63.2]; P = .003 comparing distributions). The benefit of ecallantide was apparent within 2 hours after dosing and was maintained through 24 hours after dosing. The safety profile was similar between the treatment groups.

CONCLUSION:

Ecallantide appears to be an effective and safe treatment for acute attacks of HAE.

PMID:
20568386
DOI:
10.1016/j.anai.2010.04.012
[Indexed for MEDLINE]

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