Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns

Introduction and objectives: Due to the lack of structured and systematic information available, the aim of this study was to describe the epidemiology, diagnosis, healthcare processes, and treatment patterns of hereditary angioedema (HAE) in Mexico. To achieve this, different data sources were cons...

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Main Authors: Sandra Nieto, MD, Ileana Madrigal, MD, Francisco Contreras, MD, María Eugenia Vargas
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:World Allergy Organization Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1939455123000728
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author Sandra Nieto, MD
Ileana Madrigal, MD
Francisco Contreras, MD
María Eugenia Vargas
author_facet Sandra Nieto, MD
Ileana Madrigal, MD
Francisco Contreras, MD
María Eugenia Vargas
author_sort Sandra Nieto, MD
collection DOAJ
description Introduction and objectives: Due to the lack of structured and systematic information available, the aim of this study was to describe the epidemiology, diagnosis, healthcare processes, and treatment patterns of hereditary angioedema (HAE) in Mexico. To achieve this, different data sources were consulted regarding medical literature, structured health system databases, and angioedema-specialized physicians (AEP) opinion regarding HAE. Material and methods: A mixed methods approach was conducted in 4 phases: I) systematic literature review (SLR) and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines; II) review of national health system (NHS) databases and systematic reports; III) physician survey; and IV) an epidemiologic model. ICD 10 D84.1 encoded records from the NHS were used to estimate the number of patients with HAE attended and treated during 2019. A survey was implemented to increase understanding of the clinical profile and treatments used. Results: A prevalence rate of 0.9/50 000 inhabitants was estimated for 2019. In the same year, an estimated 317 HAE type 1 patients were recorded in the NHS, aged ≥11 years old. The most frequent clinical symptoms were cutaneous edema (67.5%) and abdominal pain (47.9%). A severe episode with laryngeal edema appeared in 27.5% of cases. Acute episodes were mainly moderate to severe (77.0%), with an annual per capita frequency of emergency visits of 7.6 patient-year (range 1–12/patient-year). The main reasons for hospitalization corresponded to laryngeal facial, tongue, and abdominal edemas, representing 73.3% of annual ICD 10 D84.1 reported hospitalizations. The main treatments that patients with HAE received were fresh frozen plasma for acute attacks and danazol for short-term prophylaxis (STP). Conclusions: Despite efforts to make HAE visible, according to this study, cases recognized and treated in the NHS represent only 16.6% of the estimated prevalence.
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spelling doaj.art-6de3b1bb53b24cab84a93cb9d5427ac62023-10-13T13:53:07ZengElsevierWorld Allergy Organization Journal1939-45512023-09-01169100812Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patternsSandra Nieto, MD0Ileana Madrigal, MD1Francisco Contreras, MD2María Eugenia Vargas3Specialty in Pediatrics and Pediatric Hematology. Genetics of Nutrition Unit, Instituto Nacional de Pediatría, CDMX, MexicoSpecialty in Allergy and Immunology. High Specialty Medical Unit (UMAE), Centro Médico Nacional de Occidente, IMSS, Guadalajara, MexicoSpecialty in Pediatrics and Allergy and Clinical Immunology. Allergy and Immunology Department, Instituto Nacional de Pediatría, CDMX, MexicoSpecialty in Internal Medicine, Allergy and Clinical Immunology Master's Degree in History. Allergy and Immunology Department, Centro Médico Nacional 20 de Noviembre, ISSSTE, CDMX, Mexico; Corresponding author. Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, Ciudad de México, CDMX, 03104, MexicoIntroduction and objectives: Due to the lack of structured and systematic information available, the aim of this study was to describe the epidemiology, diagnosis, healthcare processes, and treatment patterns of hereditary angioedema (HAE) in Mexico. To achieve this, different data sources were consulted regarding medical literature, structured health system databases, and angioedema-specialized physicians (AEP) opinion regarding HAE. Material and methods: A mixed methods approach was conducted in 4 phases: I) systematic literature review (SLR) and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines; II) review of national health system (NHS) databases and systematic reports; III) physician survey; and IV) an epidemiologic model. ICD 10 D84.1 encoded records from the NHS were used to estimate the number of patients with HAE attended and treated during 2019. A survey was implemented to increase understanding of the clinical profile and treatments used. Results: A prevalence rate of 0.9/50 000 inhabitants was estimated for 2019. In the same year, an estimated 317 HAE type 1 patients were recorded in the NHS, aged ≥11 years old. The most frequent clinical symptoms were cutaneous edema (67.5%) and abdominal pain (47.9%). A severe episode with laryngeal edema appeared in 27.5% of cases. Acute episodes were mainly moderate to severe (77.0%), with an annual per capita frequency of emergency visits of 7.6 patient-year (range 1–12/patient-year). The main reasons for hospitalization corresponded to laryngeal facial, tongue, and abdominal edemas, representing 73.3% of annual ICD 10 D84.1 reported hospitalizations. The main treatments that patients with HAE received were fresh frozen plasma for acute attacks and danazol for short-term prophylaxis (STP). Conclusions: Despite efforts to make HAE visible, according to this study, cases recognized and treated in the NHS represent only 16.6% of the estimated prevalence.http://www.sciencedirect.com/science/article/pii/S1939455123000728Hereditary angioedemaPrevalence rateReal-world experienceTreatment
spellingShingle Sandra Nieto, MD
Ileana Madrigal, MD
Francisco Contreras, MD
María Eugenia Vargas
Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
World Allergy Organization Journal
Hereditary angioedema
Prevalence rate
Real-world experience
Treatment
title Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
title_full Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
title_fullStr Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
title_full_unstemmed Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
title_short Real-world experience of hereditary angioedema (HAE) in Mexico: A mixed-methods approach to describe epidemiology, diagnosis, and treatment patterns
title_sort real world experience of hereditary angioedema hae in mexico a mixed methods approach to describe epidemiology diagnosis and treatment patterns
topic Hereditary angioedema
Prevalence rate
Real-world experience
Treatment
url http://www.sciencedirect.com/science/article/pii/S1939455123000728
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