Successful Use of Lanadelumab in an Older Patient With Type II Hereditary Angioedema

Type II hereditary angioedema (HAE) is a rare, genetic disorder characterized by recurring subcutaneous and/or submucosal edema throughout the body and causes significant morbidity and mortality. Lanadelumab is a novel, long-term prophylactic treatment option for HAE and has proven to be an effective treatment option. However, data are limited in patients with type II HAE or aged ≥ 65 years. We present a case of HAE treated with lanadelumab in a patient of an underrepresented population. An 81-year-old male patient was diagnosed with type II HAE at the age of 75 years. Initially, he described having attacks of abdominal pain weekly that could last up to several days. At age 77 years, he began an on-demand treatment, icatibant, which diminished pain. However, after increasing frequency of attacks, the patient started receiving lanadelumab 300 mg subcutaneously every 2 weeks. He went from requiring on-demand treatment 2 to 3 times per month to once in 6 months. Long-term prophylaxis is critical for managing HAE patients, but data are limited for patients with type II HAE and aged ≥ 65 years. Our case supports the use of lanadelumab in these populations.