{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:08:55Z","timestamp":1791554935441,"version":"4.3.4"},"reference-count":49,"publisher":"Oceanside Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2021,1,21]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Hereditary angioedema (HAE) is a rare genetic disorder clinically characterized by recurrent attacks of subcutaneous and mucosal swelling. Attenuated androgens have been a prophylactic treatment option to reduce the frequency of HAE attacks for &gt; 4 decades.\n However, the advent of effective on-demand treatments and highly effective, more tolerable, long-term prophylactic therapies has led to a decline in the use of attenuated androgens for the management of HAE in regions where newer therapies are available. A consensus about the best approach\n for discontinuing or tapering off attenuated androgen therapy does not exist.  <jats:bold>Objective:<\/jats:bold> To develop a consensus on androgen tapering for patients with HAE.  <jats:bold>Methods:<\/jats:bold> We sent an open-ended survey about androgen tapering to 21 physicians who treat HAE,\n 12 of whom responded. We reviewed the collective experience of the participating physicians in combination with results from a literature review on the topic.  <jats:bold>Results:<\/jats:bold> The survey and literature review underscored potential concerns related to rapid androgen withdrawal in\n patients with HAE, including physician and patient concerns that the frequency and severity of attacks would abruptly worsen. In addition, discontinuation of attenuated androgens may have the potential for transient adverse effects, such as an increase in the rate of attacks or effects related\n to hormone withdrawal. Our survey showed that physicians often taper androgens to prevent increases in HAE attacks and possible withdrawal complications.  <jats:bold>Conclusion:<\/jats:bold> Based on both experiences of the physicians who responded to our survey and reports in the endocrine literature,\n we provided recommendations for androgen tapering. However, we noted that the likelihood of adverse effects due to androgen withdrawal in patients with HAE is poorly understood and requires further study.<\/jats:p>","DOI":"10.2500\/aap.2021.42.200106","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T01:06:23Z","timestamp":1608599183000},"page":"22-29","source":"Crossref","is-referenced-by-count":26,"title":["Androgen use in hereditary angioedema: A critical appraisal and approaches to transitioning from androgens to other therapies"],"prefix":"10.2500","volume":"42","author":[{"given":"Douglas T.","family":"Johnston","sequence":"first","affiliation":[{"name":"From the Asthma and Allergy Specialists, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Henry Li","sequence":"additional","affiliation":[{"name":"Institute for Asthma and Allergy, Chevy Chase, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Medicine and Pediatrics, Penn State University, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Allergy Section, Division of Immunology, Department of Internal Medicine, University of Cincinnati;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Anderson","sequence":"additional","affiliation":[{"name":"Clinical Research Center of Alabama, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kusumam","family":"Joseph","sequence":"additional","affiliation":[{"name":"BioCryst Pharmaceuticals Inc., Durham, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Riedl","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13023-018-0815-5","article-title":"Epidemiology of bradykinin-mediated angioedema: a systematic investigation of epidemiological studies","volume":"13","author":"Aygoren-Pursun","year":"2018","journal-title":"Orphanet J Rare Dis"},{"key":"B2","first-page":"S292","article-title":"Severity of hereditary angioedema, prevalence, and diagnostic considerations","volume":"24","author":"Bernstein","year":"2018","journal-title":"Am J Manag Care"},{"key":"B3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1710-1492-6-23","article-title":"HAE therapies: past present and future","volume":"6","author":"Zuraw","year":"2010","journal-title":"Allergy Asthma Clin Immunol"},{"key":"B4","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1056\/NEJMra1808012","article-title":"Hereditary angioedema","volume":"382","author":"Busse","year":"2020","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.jaip.2016.03.024","article-title":"Tolerability and effectiveness of 17-alpha-alkylated androgen therapy for hereditary angioedema: a re-examination","volume":"4","author":"Zuraw","year":"2016","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B6","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1365-2362.2010.02402.x","article-title":"Long-term efficacy of danazol treatment in hereditary angioedema","volume":"41","author":"Fust","year":"2011","journal-title":"Eur J Clin Invest"},{"key":"B7","doi-asserted-by":"crossref","first-page":"371","DOI":"10.2500\/aap.2014.35.3783","article-title":"Quality of life in patients with hereditary angioedema receiving therapy for routine prevention of attacks","volume":"35","author":"Lumry","year":"2014","journal-title":"Allergy Asthma Proc"},{"key":"B8","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1177\/0363546503262202","article-title":"Current concepts in anabolic-androgenic steroids","volume":"32","author":"Evans","year":"2004","journal-title":"Am J Sports Med"},{"key":"B9","doi-asserted-by":"crossref","first-page":"146","DOI":"10.2174\/1570159X13666141210225414","article-title":"Anabolic androgenic steroid (AAS) related deaths: autoptic, histopathological and toxicological findings","volume":"13","author":"Frati","year":"2015","journal-title":"Curr Neuropharmacol"},{"key":"B10","doi-asserted-by":"crossref","first-page":"326","DOI":"10.2165\/00007256-199519050-00003","article-title":"Anabolic-androgenic steroids. 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