Consenso de expertos mexicanos acerca de la profilaxis a largo plazo en pacientes con angioedema hereditario en México.

Saved in:

Bibliographic Details
Title:	Consenso de expertos mexicanos acerca de la profilaxis a largo plazo en pacientes con angioedema hereditario en México.
Alternate Title:	Consensus of Mexican experts on long-term prophylaxis in patients with hereditary angioedema in Mexico.
Authors:	Guidos Fogelbach, Guillermo Arturo¹, Velasco Medina, Andrea Aida² a2velascom@gmail.com, Campos Romero, Freya Helena³, Rojo Gutiérrez, María Isabel⁴, Nieto Martínez, Sandra Agustina⁵, Beas Madrigal, Ileana María⁶, López Tiro, José Jesus⁷, Albarrán Godínez, Antonio⁸, Vargas Camaño, María Eugenia⁹, Matta Campos, Juan José¹⁰, del Refugio Morfin Maciel, Blanca María¹¹, Piñeyro Beltrán, Eduardo Enrique¹²
Source:	Revista Alergia de Mexico. ene-mar2026, Vol. 73 Issue 1, p93-104. 12p.
Subjects:	DIAGNOSIS, PREVENTIVE medicine, HEALTH services accessibility, MEDICAL protocols, MONOCLONAL antibodies, ANGIONEUROTIC edema
Geographic Terms:	MEXICO
Abstract (English):	BACKGROUND: Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent, bradykinin-mediated swelling episodes, with substantial impact on morbidity, quality of life, and healthcare resource use. Targeted agents have reshaped long-term prophylaxis (LTP); however, effective implementation depends on clinical decision-making as well as health-system access and structural constraints. OBJECTIVE: To comprehensively describe HAE long-term prophylaxis management in Mexico, focusing on the diagnostic approach, LTP use, treatment access and availability, perceived disease control, and applicability of clinical recommendations, based on structured national expert opinion. METHODS: We conducted a descriptive and analytical evaluation of Mexico-specific data derived from a structured Delphi process involving clinicians experienced in HAE management. Assessed domains included diagnostic testing practices, selection and prescribing frequency of LTP therapies, use of non-recommended treatments, funding sources, medication availability issues, access barriers, and clinicians’ perceptions regarding disease control and guideline applicability. RESULTS: Experts reported strong conceptual alignment with current clinical recommendations. LTP prescribing was predominantly concentrated on lanadelumab, with limited use of C1-INH concentrates and no reported use of berotralstat. Despite reported public coverage, frequent barriers related to availability and cost constrained effective access and treatment continuity. Clinical guidelines were perceived as highly applicable; however, a gap between recommended care and feasible real-world implementation was consistently acknowledged. CONCLUSIONS: HAE prophylaxis management in Mexico appears aligned with contemporary standards, yet sustained and individualized implementation remains limited by structural access and supply constraints. Key priorities include strengthening timely diagnosis, ensuring continuous access to targeted therapies, and standardizing follow-up in routine clinical care. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	ANTECEDENTES: El angioedema hereditario es una enfermedad genética rara y potencialmente mortal, caracterizada por episodios recurrentes de edema subcutáneo y submucosa mediado por bradicinina, con impacto sustancial en la morbilidad, la calidad de vida y el uso de recursos sanitarios. La incorporación de nuevas terapias dirigidas ha modificado el paradigma de la profilaxis de largo plazo; sin embargo, su implementación depende de condiciones clínicas y, de forma crítica, determinantes estructurales y de acceso, propios del sistema de salud. OBJETIVO: Caracterizar de manera integral el tratamiento profiláctico del angioedema hereditario en México, con énfasis en el diagnóstico, la profilaxis a largo plazo, el acceso y la disponibilidad terapéutica, la percepción del control de la enfermedad y la aplicabilidad de recomendaciones clínicas, a partir de la opinión estructurada de especialistas nacionales. MÉTODOS: Análisis descriptivo y analítico de los datos correspondientes a México obtenidos mediante un ejercicio Delphi estructurado, con especialistas con experiencia en el tratamiento de angioedema hereditario. Se evaluaron las prácticas de diagnóstico, el proceso de selección y prescripción de terapias profilácticas, tratamientos poco recomendados, problemas de disponibilidad y acceso, y percepción clínica del control de la enfermedad y la aplicabilidad de guías internacionales. RESULTADOS: Los especialistas reportaron una alta alineación conceptual con las recomendaciones clínicas vigentes. La profilaxis a largo plazo se centró predominantemente en lanadelumab, con uso limitado de concentrados de C1-INH y ausencia de berotralstat. Aunque el sistema de salud público otorga cobertura del tratamiento, persisten las barreras relacionadas con disponibilidad y costos, lo que condicionó el acceso efectivo y la continuidad terapéutica. Las guías clínicas fueron consideradas altamente aplicables; no obstante, se identificó una brecha entre el tratamiento recomendado y el factible en la práctica cotidiana. CONCLUSIONES: El tratamiento profiláctico de pacientes con angioedema hereditario en México refleja avances clínicos relevantes y un enfoque alineado con estándares contemporáneos; sin embargo, persisten limitaciones estructurales que restringen la implementación sostenida e individualizada de la profilaxis. Entre las áreas prioritarias se incluyen el fortalecimiento del diagnóstico oportuno, el aseguramiento del acceso continuo a terapias dirigidas y la estandarización del seguimiento clínico. [ABSTRACT FROM AUTHOR]
	Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database:	MedicLatina

Description
Abstract:	BACKGROUND: Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent, bradykinin-mediated swelling episodes, with substantial impact on morbidity, quality of life, and healthcare resource use. Targeted agents have reshaped long-term prophylaxis (LTP); however, effective implementation depends on clinical decision-making as well as health-system access and structural constraints. OBJECTIVE: To comprehensively describe HAE long-term prophylaxis management in Mexico, focusing on the diagnostic approach, LTP use, treatment access and availability, perceived disease control, and applicability of clinical recommendations, based on structured national expert opinion. METHODS: We conducted a descriptive and analytical evaluation of Mexico-specific data derived from a structured Delphi process involving clinicians experienced in HAE management. Assessed domains included diagnostic testing practices, selection and prescribing frequency of LTP therapies, use of non-recommended treatments, funding sources, medication availability issues, access barriers, and clinicians’ perceptions regarding disease control and guideline applicability. RESULTS: Experts reported strong conceptual alignment with current clinical recommendations. LTP prescribing was predominantly concentrated on lanadelumab, with limited use of C1-INH concentrates and no reported use of berotralstat. Despite reported public coverage, frequent barriers related to availability and cost constrained effective access and treatment continuity. Clinical guidelines were perceived as highly applicable; however, a gap between recommended care and feasible real-world implementation was consistently acknowledged. CONCLUSIONS: HAE prophylaxis management in Mexico appears aligned with contemporary standards, yet sustained and individualized implementation remains limited by structural access and supply constraints. Key priorities include strengthening timely diagnosis, ensuring continuous access to targeted therapies, and standardizing follow-up in routine clinical care. [ABSTRACT FROM AUTHOR]
ISSN:	00025151
DOI:	10.29262/ram.v73i1.1584