Lanadelumab

How it works

It inhibits plasma kallikrein, reducing the generation of bradykinin and thereby preventing the bradykinin-driven swelling that characterises hereditary angioedema attacks.

Prescribing in practice

• It is a preventive therapy and does not treat acute attacks, so patients must retain access to, and a plan for, on-demand acute treatment for breakthrough attacks.
• Administered by subcutaneous injection on a regular schedule and may be self-administered or carer-administered after training; injection-site reactions are common.
• Hypersensitivity reactions have been reported; consult the SPC for the prescribing detail.

Monitoring

Monitor attack frequency and severity to assess response, alongside injection-site and hypersensitivity reactions.

Counselling the patient

• This injection is to prevent attacks and will not treat one that is already happening.
• Keep your emergency (on-demand) treatment available and know when to use it.
• Injection-site redness or pain is common and usually short-lived.

Evidence & guidelines

Lanadelumab is licensed for hereditary angioedema prophylaxis based on the HELP trial, which showed a substantial reduction in attack frequency, and is recommended by NICE for preventing recurrent attacks in eligible patients.