Side effects of long-term prophylaxis with attenuated androgens in hereditary angioedema: Comparison of treated and untreated patients☆,☆☆,★
Section snippets
Methods
We studied 24 men and 46 women with HAE. The diagnosis was based on personal and family history of recurrent angioedema symptoms and low levels of functional C1-inhibitor. Eight men and 28 women (age range, 22 to 74 years; median age, 44 years) had been receiving prophylactic treatment with attenuated androgens (danazol, stanozolol, or both in different periods). Fifteen men and 18 women (age range, 15 to 67 years; median age, 44 years) who had never received attenuated androgens or any other
Results
Five patients were treated only with danazol, 31 with danazol and stanozolol in different periods, and none with stanozolol only. The dose was established on a clinical basis as the minimal dose at which the patient remained nearly free of symptoms (i.e, 2 or fewer minor attacks per year). This daily dose ranged from 1 to 2 mg for stanozolol and from 50 to 200 mg for danazol. Two patients receiving stanozolol and six receiving danazol, although experiencing two to six minor attacks per year,
Discussion
Attenuated androgens became the treatment of choice for severe HAE almost 20 years ago. Their extraordinary effectiveness changed the quality of life for patients with this disease. However, because the treatment may easily last throughout life (major contraindications are limited to childhood and pregnancy), their long-term toxicity needs to be continually assessed.
The data reported in this article suggest that stanozolol is slightly more effective than danazol, probably because its fewer side
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2016, Journal of Allergy and Clinical Immunology: In Practice
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From the Institute of Internal Medicine University of Milan, Istituto di Ricovera e Cura a Carattere Scientifico, Ospedale Maggiore.
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Reprint requests: Angelo Agostoni, MD, Istituto di Medicina Interna, Via Pace 15, 20122 Milano, Italy.
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