Hereditary Angioedema

To the Editor: In their review of hereditary angioedema, Busse and Christiansen (March 19 issue) 1 suggest that plasma-derived C1 inhibitor is the preferred short-term prophylactic agent to be used before any medical or surgical procedures are performed and that recombinant human C1 inhibitor, icatibant, and ecallantide are not preferred owing to the shorter half-lives of these drugs. In a case series of 51 patients who underwent a total of 70 dental or surgical procedures, the attack rate after 48 hours was 2.9% among those who received recombinant human C1 inhibitor prophylaxis as compared with 76.9% among those who did not. 2 . . .