Feasibility of Home Infusion and Self-Administration of Nanofiltered C1 Esterase Inhibitor for Routine Prophylaxis in Patients With Hereditary Angioedema and Characterization of a Training and Support Program

Gregory, Cherylann; Landmesser, Ladonna M.; Corrigan, Larry; Mariano, David

doi:10.1097/nan.0000000000000018

Cited by 9 publications

(14 citation statements)

References 23 publications

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“…One study has shown that when a comprehensive self‐administration training programme is implemented, rates of self‐administration of C1 inhibitor increased from 20.3% to 43.9% within 2 years across all patient groups. The average of five visits to be successfully trained in self‐administration in this current European analysis was similar to that observed in a study conducted in the USA …”

Section: Discussionsupporting

confidence: 86%

An analysis of the teaching of intravenous self-administration in patients with hereditary angio-oedema

Mühlberg¹,

Ettl²,

Magerl

2016

Clin Exp Dermatol

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C1 inhibitor self-administration for the treatment of HAE allows patients to quickly treat attacks at home, potentially reducing attack severity. The results also demonstrate the benefit of self-administered routine prevention therapy in a real-world patient population. Self-administered therapy potentially allows patients to gain greater control over their attacks, resulting in a reduction in healthcare utilization.

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Section: Discussionsupporting

confidence: 86%

An analysis of the teaching of intravenous self-administration in patients with hereditary angio-oedema

Mühlberg¹,

Ettl²,

Magerl

2016

Clin Exp Dermatol

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“…Overall, patients and family members reacted positively to the proposal of using self-administration, with a proportion of patients switching to home therapy similar to that observed in other studies [34][35][36] . For example, a recently published Danish study that followed 80 C1-INH-HAE patients for 11 years found that by the end of 2012, forty-nine percent of the patients were practicing self-therapy for acute attacks [34] .…”

Section: Discussionsupporting

confidence: 61%

“…It is also possible that some of our patients might have benefitted from additional training and assistance at home. Notably, 2 recent studies investigating the feasibility of C1-INH concentrate self-administration found that on average patients needed 5 training sessions at home to be trained, and that the preferred form of teaching was at home by a visiting nurse in the presence of a family member or caregiver [35,37] . As recommended by current guidelines, refresher training at regular intervals may also help to further improve and maintain the acquired skills [17] .…”

Section: Discussionmentioning

confidence: 99%

Home Therapy with Plasma-Derived C1 Inhibitor: A Strategy to Improve Clinical Outcomes and Costs in Hereditary Angioedema

Petraroli

Squeglia

Paola³

et al. 2015

Int Arch Allergy Immunol

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Background: Attacks of hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) are commonly treated in the emergency department. Self-administration is emerging as an effective treatment option. In this study, we assessed the impact of home therapy with plasma-derived C1 esterase inhibitor (pdC1-INH) concentrate on treatment outcomes and costs. Methods: This is an observational study in C1-INH-HAE patients who switched to home therapy with pdC1-INH (Berinert®) after learning intravenous self-infusion in a training course at a center in Southern Italy. Before starting home therapy and after the first year of home therapy, patients were interviewed about their treatment and outcomes during the prior 12 months. Annual costs were analyzed by cost minimization from the Italian health care payer perspective and the societal perspective. Outcomes and costs before and after the switch to home therapy were compared. Results: The training course was attended by 36 participants, 17 (47.2%) of whom decided to switch to home therapy. This therapy was associated with a significant decrease in the mean annual number of hospitalizations (16.8 vs. 2.1, p = 0.003) and missed work/school days (20.3 vs. 7.1, p = 0.037) compared to conventional treatment. The times from symptom onset to treatment administration and from treatment administration to symptom improvement/resolution were not significantly different between the two strategies. The mean annual per-patient costs decreased with home therapy from EUR 30,010.57 to EUR 26,621.16 (11.3% saving) and from EUR 29,309.34 to EUR 26,522.04 (9.5% saving) from the societal and payer perspective, respectively. Conclusions: Home therapy with pdC1-INH is a feasible strategy for the management of C1-INH-HAE and may result in cost savings.

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“…17 A descriptive analysis of database information from the United States reported that the 75% of children younger than 12 years of age were able to receive home therapy with pdC1INH after the implementation of a home therapy training program, and one child was able to self-administer home therapy. 18 …”

Section: Rationale For Home Therapy For Pediatric Haementioning

confidence: 97%

Hereditary Angioedema: Moving Therapy into the Home and to Self-Care

BetschelStephen

JagdisAmanda

2014

Pediatric Allergy, Immunology, and Pulmonology

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Hereditary angioedema (HAE) is a condition that results in recurrent and often unpredictable attacks of angioedema, which is associated with significant morbidity and can be fatal. The majority of literature related to management of HAE has focused on the adult patient. There is limited information on treatment and management strategies for the pediatric HAE population. Comprehensive care has been repeatedly recommended in international guidelines for the optimal management of HAE. Home therapy is a critical pillar of such a comprehensive care plan. Hemophilia is similar to HAE in that it is a serious rare blood disorder for which comprehensive care is considered essential. There is a paucity of literature on home therapy as it relates to the pediatric HAE patient population. This review outlines the rationale for home therapy in the management of pediatric HAE by drawing on the experience in pediatric hemophilia and placing it in the specific context of HAE management principles.

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Feasibility of Home Infusion and Self-Administration of Nanofiltered C1 Esterase Inhibitor for Routine Prophylaxis in Patients With Hereditary Angioedema and Characterization of a Training and Support Program

Cited by 9 publications

References 23 publications

An analysis of the teaching of intravenous self-administration in patients with hereditary angio-oedema

An analysis of the teaching of intravenous self-administration in patients with hereditary angio-oedema

Home Therapy with Plasma-Derived C1 Inhibitor: A Strategy to Improve Clinical Outcomes and Costs in Hereditary Angioedema

Hereditary Angioedema: Moving Therapy into the Home and to Self-Care

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