Acute treatment of edematous episodes of hereditary angioedema (HAE)

	Laryngeal attack	Abdominal attack	Cutaneous attack
	Laryngeal attack	Abdominal attack	Extremities, trunk	Face, neck
C1-INH concentrate (plasma derived or recombinant) given intravenously	Yes	Yes	Yes, unless swelling is extremely mild and not causing disability	Yes
Ecallantide (United States only)	Yes	Yes	Yes, unless extremely mild	Yes
Icatibant	Yes	Yes	Yes, unless extremely mild	Yes
Plasma (solvent/detergent treated or fresh frozen)	Yes, if first-line therapies are not available	Yes, if first-line therapies are not available	Yes, if severe and first-line therapies are not available	Yes
*Intubation, transfer to ICU, rarely emergent tracheotomy**	Yes (consider early intubation if above agents are not available)	Not applicable	Not applicable	May be necessary if attack spreads to involve upper airway
Wait and see (spontaneous resolution)	Not sufficient	Not recommended unless symptoms are mild and first-line therapies are not available	Acceptable if mild	Not sufficient (because angioedema can spread to involve upper airway)

All HAE attacks should be treated as early as possible, at first sign of prodromal symptoms and before the attack becomes fully established.

C1-INH: C1 inhibitor; ICU: intensive care unit.

* Consider intubation early in setting of progressive laryngeal edema or if C1-INH preparations, ecallantide, or icatibant are not available.

Modified with permission from: Bowen T, Cicardi M, Farkas H, et al. 2010 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Allergy, Asthma, and Clinical Immunology; 2010; 6:24. Copyright © 2010 BioMed Central Ltd.

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Acute treatment of edematous episodes of hereditary angioedema (HAE)