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2026, Vol: 10, Issue: 6
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Review Article
Online Published: 13 Dec 2025
 


The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review

Fahad Abdulkarim Binsebail, Rawan Alanazi, Hessa Almutairi, Wasan Almutairi, Omar Abdulaziz Alsuwailem, Alia Zamandar, Nojoud Alajroush.


Abstract
Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable swelling attacks due to bradykinin. In recent years, the therapeutic landscape has evolved significantly with the introduction of targeted therapies, necessitating a comprehensive review of their efficacy and safety. Following PRISMA 2020 guidelines, a systematic review of randomized controlled trials (RCTs) was conducted from 2014 to 2025, sourced from PubMed, Scopus, Medline, and Web of Science. The search focused on HAE therapies, including C1-esterase inhibitors, bradykinin B2 receptor antagonists, and kallikrein inhibitors. Outcomes included attack frequency, time to relief, quality of life (QoL), and adverse events (AEs). Five Phase III RCTs were included. Prophylactic treatments [berotralstat, subcutaneous C1-esterase inhibitor (C1-INH), lanadelumab] achieved attack rate reductions of 84.8%-95%, with monthly attack rates of ≤0.53. Significant improvements in QoL metrics (AE-QoL, TSQM, EQ-5D) were observed. AEs were primarily mild to moderate (e.g., nasopharyngitis, injection-site reactions). For acute treatment, recombinant human C1-INH provided significantly faster symptom relief (median 90 minutes) compared to placebo (152 minutes). Contemporary HAE therapies demonstrated high efficacy and acceptable safety profiles for both prophylaxis and acute treatment. Treatment choice should be individualized, with injectable therapies offering optimal control and oral options providing a needle-free alternative. Future research should prioritize head-to-head comparisons and long-term realworld evidence.

Key words: Efficacy, safety, hereditary angioedema, therapeutic strategies, systematic review.


 
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How to Cite this Article
Pubmed Style

Binsebail FA, Alanazi R, Almutairi H, Almutairi W, Alsuwailem OA, Zamandar A, Alajroush N. The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. IJMDC. 2025; 9(11): 2947-2955. doi:10.24911/IJMDC.51-1762183946

Web Style

Binsebail FA, Alanazi R, Almutairi H, Almutairi W, Alsuwailem OA, Zamandar A, Alajroush N. The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. https://www.ijmdc.com/?mno=294332 [Access: June 23, 2026]. doi:10.24911/IJMDC.51-1762183946

AMA (American Medical Association) Style

Binsebail FA, Alanazi R, Almutairi H, Almutairi W, Alsuwailem OA, Zamandar A, Alajroush N. The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. IJMDC. 2025; 9(11): 2947-2955. doi:10.24911/IJMDC.51-1762183946


Vancouver/ICMJE Style

Binsebail FA, Alanazi R, Almutairi H, Almutairi W, Alsuwailem OA, Zamandar A, Alajroush N. The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. IJMDC. (2025), [cited June 23, 2026]; 9(11): 2947-2955. doi:10.24911/IJMDC.51-1762183946


Harvard Style

Binsebail, F. A., Alanazi, . R., Almutairi, . H., Almutairi, . W., Alsuwailem, . O. A., Zamandar, . A. & Alajroush, . N. (2025) The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. IJMDC, 9 (11), 2947-2955. doi:10.24911/IJMDC.51-1762183946


Turabian Style

Binsebail, Fahad Abdulkarim, Rawan Alanazi, Hessa Almutairi, Wasan Almutairi, Omar Abdulaziz Alsuwailem, Alia Zamandar, and Nojoud Alajroush. 2025. The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2947-2955. doi:10.24911/IJMDC.51-1762183946


Chicago Style

Binsebail, Fahad Abdulkarim, Rawan Alanazi, Hessa Almutairi, Wasan Almutairi, Omar Abdulaziz Alsuwailem, Alia Zamandar, and Nojoud Alajroush. "The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review." International Journal of Medicine in Developing Countries 9 (2025), 2947-2955. doi:10.24911/IJMDC.51-1762183946


MLA (The Modern Language Association) Style

Binsebail, Fahad Abdulkarim, Rawan Alanazi, Hessa Almutairi, Wasan Almutairi, Omar Abdulaziz Alsuwailem, Alia Zamandar, and Nojoud Alajroush. "The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review." International Journal of Medicine in Developing Countries 9.11 (2025), 2947-2955. Print. doi:10.24911/IJMDC.51-1762183946


APA (American Psychological Association) Style

Binsebail, F. A., Alanazi, . R., Almutairi, . H., Almutairi, . W., Alsuwailem, . O. A., Zamandar, . A. & Alajroush, . N. (2025) The effectiveness and safety of therapeutic strategies for hereditary angioedema: a systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2947-2955. doi:10.24911/IJMDC.51-1762183946




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