Assessment of inhibitory antibodies in patients with hereditary angioedema treated with plasma-derived C1 inhibitor

作者:Farkas Henriette; Varga Lilian; Moldovan Dumitru; Obtulowicz Krystyna; Shirov Todor; Machnig Thomas; Feuersenger Henrike; Edelman Jonathan; Williams Herman Debora; Rojavin Mikhail*
来源:Annals of Allergy Asthma & Immunology, 2016, 117(5): 508-513.
DOI:10.1016/j.anai.2016.08.025

摘要

Background: Limited data are available regarding C1 inhibitor (C1-INH) administration and anti-C1-INH antibodies. Objective: To assess the incidence of antibody formation during treatment with pasteurized, nanofiltered plasma-derived C1-INH (pnfC1-INH) in patients with hereditary angioedema with C1-INH deficiency (C1-INH-HAE) and the comparative efficacy of pnfC1-INH in patients with and without antibodies. Methods: In this multicenter, open-label study, patients with C1-INH-HAE (>= 12 years of age) were given 20 IU/kg of pnfC1-INH per HAE attack that required treatment and followed up for 9 months. Blood samples were taken at baseline (day of first attack) and months 3, 6, and 9 and analyzed for inhibitory anti-C1-INH antibody (iC1-INH-Ab) and noninhibitory anti-C1-INH antibodies (niC1-INH-Abs). Results: The study included 46 patients (69.6% female; mean age, 38.9 years; all white) who received 221 on-site pnfC1-INH infusions; most patients received 6 or fewer infusions. No patient tested positive (titer >= 1:50) for iC1-INH-Ab at any time during the study. Thirteen patients (28.2%) had detectable niC1-INH-Abs in 1 or more samples. Nine patients (19.6%) had detectable niC1-INH-Abs at baseline; 3 of these had no detectable antibodies after baseline. Of 10 patients (21.7%) with 1 or more detectable result for niC1-INH-Abs after baseline, 6 had detectable niC1-INH-Abs at baseline. Mean times to symptom relief onset and complete symptom resolution per patient were similar for those with or without anti-niC1-INH-Abs. Conclusion: Administration of pnfC1-INH was not associated with iC1-INH-Ab formation in this population. Noninhibitory antibodies were detected in some patients but fluctuated during the study independently of pnfC1-INH administration and appeared to have no effect on pnfC1-INH efficacy.

  • 出版日期2016-11