Lanadelumab Significantly Lowers Hereditary Angioedema Attacks vs Berotralstat

A significantly lower monthly rate of hereditary angioedema (HAE) attacks is associated with lanadelumab treatment every other week vs daily berotralstat, according to results of analysis presented at the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting, held from November 10 to 14, in Louisville, Kentucky.

Researchers aimed to estimate the comparative effectiveness of lanadelumab vs berotralstat over 48 weeks of treatment. The primary endpoint was the HAE attack rate per 28 days.

The investigators conducted a matching-adjusted indirect comparison (MAIC) retrospective analysis using data from the HELP open-label extension trial (HELP OLE; ClinicalTrials.gov Identifier: NCT02741596), and from the APeX-2 trial (ClinicalTrials.gov Identifier: NCT03485911).

Researchers found a statistically significant 73% lower HAE attack rate per 28 days with lanadelumab 300 mg taken every 2 weeks vs daily berotralstat 150 mg over 48 weeks of treatment (rate ratio [RR] 0.27; 95% CI, 0.24-0.31; P <.00001). For patients from the HELP OLE study who rolled over from the lanadelumab 300 mg arm, subgroup analysis showed a statistically significant 81% lower HAE attack rate per 28 days associated with lanadelumab 300 mg vs berotralstat 150 mg over 48 weeks of treatment (RR 0.19; 95% CI, 0.12-0.29; P <.0001).

Researchers said in conclusion, “In this MAIC, lanadelumab 300 mg Q2W was associated with a statistically significantly lower rate of HAE attacks per 28 days vs berotralstat 150 mg QD at 48 weeks of treatment.”