Instilling IV Confidence: Self-Administration in HAE

We’re back with John Anderson, MD, clinical assistant professor at The University of Alabama at Birmingham and partner at AllerVie Health, and Shahnaz Fatteh, MD, physician at the Asthma, Allergy Care Center of Florida, as they address clinician questions around intravenous (IV) self-administration within the context of RUCONEST® (C1 esterase inhibitor [recombinant]). RUCONEST can be administered via IV self-administration and is indicated to treat acute attacks in adult and adolescent patients with hereditary angioedema (HAE). We are delighted to welcome Kelly, a patient with HAE, who will share their experience learning to confidently self-administer an IV. Practical approaches for discussing IV self-administration with patients will be explored. In addition, an overview of RUCONEST training resources for IV self-administration will be highlighted.

WHAT IS RUCONEST? 

RUCONEST® (C1 esterase inhibitor[recombinant]) is indicated for the treatment of acute attacks in adult and adolescent patients with hereditary angioedema (HAE). Effectiveness in clinical studies was not established in HAE patients with laryngeal attacks.

IMPORTANT SAFETY INFORMATION 

RUCONEST is contraindicated in patients with a history of allergy to rabbits or rabbit-derived products and for patients with a history of life-threatening immediate hypersensitivity reactions, including anaphylaxis, to C1 esterase inhibitor (C1-INH) preparations.

Monitor patients for early signs of allergic or hypersensitivity reactions (including hives, generalized urticaria, tightness of the chest, wheezing, hypotension, and/or anaphylaxis). If symptoms occur, discontinue RUCONEST and administer appropriate treatment.

Serious arterial and venous thromboembolic (TE) events have been reported with plasma-derived C1-INH products. Risk factors may include the presence of an indwelling venous catheter/access device, prior history of thrombosis, underlying atherosclerosis, use of oral contraceptives or certain androgens, morbid obesity, and immobility. Monitor patients with known risk factors for TE events during and after RUCONEST administration.

Appropriately trained patients may self-administer RUCONEST upon recognition of an HAE attack. Advise patients to seek medical attention if progress of any attack makes them unable to properly prepare or administer a dose of RUCONEST. No more than 2 doses should be administered within a 24-hour period.  

The serious adverse reaction reported in clinical trials was anaphylaxis. The most common adverse reactions (incidence ≥2%) were headache, nausea, and diarrhea.  

Before prescribing RUCONEST, please read the full Prescribing Information including the Patient Product Information. 

DISCLAIMER 

This educational program is sponsored by Pharming Healthcare, Inc. The speakers have been compensated for the presentation of this information. The information contained within this podcast is for educational purposes only and is not intended to be medical advice. Patient experiences may be discussed in this episode. It is important to recognize that these experiences may not be representative, as every patient has a unique disease course. This activity is not intended for Continuing Medical Education credits.

EPISODE REFERENCE LIST 

1. Busse PJ, Christiansen SC, Riedl MA, et al. US HAEA Medical Advisory Board 2020 guidelines for the management of hereditary angioedema. J Allergy Clin Immunol Pract. 2021;9(1):132-150.e3. doi:10.1016/j.jaip.2020.08.046 
2. Jacobs J, Neeno T. The importance of recognizing and managing a rare form of angioedema: hereditary angioedema due to C1-inhibitor deficiency. Postgrad Med. 2021;133(6):639-650. doi:10.1080/00325481.2021.1905364 
3. Price G, Patel DA. Drug bioavailability. In: StatPearls Internet. StatPearls Publishing; 2023. Updated June 23, 2022. Accessed November 22, 2023. https://www.ncbi.nlm.nih.gov/books/NBK557852/ 
4. Ruconest. Prescribing information. Pharming Healthcare Inc; 2020. 
5. Maurer M, Magerl M, Betschel S, et al. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update. Allergy. 2022;77(7):1961-1990. doi:10.1111/all.15214 
6. Fields T, Ghebrehiwet B, Kaplan AP. Kinin formation in hereditary angioedema plasma: evidence against kinin derivation from C2 and in support of "spontaneous" formation of bradykinin. J Allergy Clin Immunol. 1983;72(1):54-60. 
7. What to expect. Ruconest. Accessed February 13, 2023. https://www.ruconest.com/patient-support/ 
8. How to self-administer. Ruconest. Accessed February 13, 2023. https://www.ruconest.com/dosing-administration/ 
9. Data on file. Pharming Healthcare Inc; 2019.