Comparison of Clinical Characteristics Between Hereditary Angioedema Patients Aged 65 Years and Older and Those Under 65: A Perspective on Elderly Patients

TL;DR

This study compares the clinical features of older and younger patients with hereditary angioedema, highlighting differences in diagnosis, treatment, and disease control.

Contribution

The study provides new insights into the clinical management and disease expression of hereditary angioedema in elderly patients compared to younger individuals.

Findings

Elderly patients had a higher median age at diagnosis and a significant delay in diagnosis.

Elderly patients had lower angioedema control in the last three months despite similar annual attack rates.

Short-term prophylaxis use was higher in elderly patients compared to younger ones.

Abstract

Background: This study aimed to comprehensively define the clinical profile of elderly patients with hereditary angioedema (HAE) caused by C1 esterase inhibitor (C1INH) deficiency and/or dysfunction (HAE-C1INH). Furthermore, it sought to reveal age-related differences in disease expression and management by comparing these patients with their younger counterparts. Methods: In this retrospective study, seventy-six patients were included. All patients had been diagnosed with HAE-C1INH. Results: A total of 9 (12%) patients were ≥65 years, 7 (77%) of whom were female. The median age at the time of diagnosis was higher in the elderly group, whereas the median age at the first symptom was similar. There was a significant delay in diagnosis time in the elderly group. Hypertension was the most frequent comorbidity among elderly patients. The median number of angioedema attacks in the last year was 6, and similar to 10 in patients < 65 years. Angioedema control in the last three months was lower in older patients. The rate of laryngeal edema was similar in patients < 65 years and older patients. The use of short-term prophylaxis (STP) was higher in the elderly group. The most commonly used treatment for acute attacks was pdC1-INH. Two patients in the elderly group did not benefit from danazol. No adverse events with icatibant, pdC1-INH, danazol were encountered among patients. Conclusions: Compared to patients younger than 65 years of age, annual attack rates were similar, whereas elderly patients had lower angioedema control for the last three months. The use of STP rates was higher among elderly patients.

Figures