{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:44:56Z","timestamp":1776721496155,"version":"3.51.2"},"reference-count":28,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>ANTECEDENTES: El angioedema hereditario es una enfermedad gen\u00e9tica rara y potencialmente mortal, caracterizada por episodios recurrentes de edema subcut\u00e1neo y submucosa mediado por bradicinina, con impacto sustancial en la morbilidad, la calidad de vida y el uso de recursos sanitarios. La incorporaci\u00f3n de nuevas terapias dirigidas ha modificado el paradigma de la profilaxis de largo plazo; sin embargo, su implementaci\u00f3n depende de condiciones cl\u00ednicas y, de forma cr\u00edtica, determinantes estructurales y de acceso, propios del sistema de salud.\nOBJETIVO: Caracterizar de manera integral el tratamiento profil\u00e1ctico del angioedema hereditario en M\u00e9xico, con \u00e9nfasis en el diagn\u00f3stico, la profilaxis a largo plazo, el acceso y la disponibilidad terap\u00e9utica, la percepci\u00f3n del control de la enfermedad y la aplicabilidad de recomendaciones cl\u00ednicas, a partir de la opini\u00f3n estructurada de especialistas nacionales.\nM\u00c9TODOS: An\u00e1lisis descriptivo y anal\u00edtico de los datos correspondientes a M\u00e9xico obtenidos mediante un ejercicio Delphi estructurado, con especialistas con experiencia en el tratamiento de angioedema hereditario. Se evaluaron las pr\u00e1cticas de diagn\u00f3stico, el proceso de selecci\u00f3n y prescripci\u00f3n de terapias profil\u00e1cticas, tratamientos poco recomendados, problemas de disponibilidad y acceso, y percepci\u00f3n cl\u00ednica del control de la enfermedad y la aplicabilidad de gu\u00edas internacionales.\nRESULTADOS: Los especialistas reportaron una alta alineaci\u00f3n conceptual con las recomendaciones cl\u00ednicas vigentes. La profilaxis a largo plazo se centr\u00f3 predominantemente en lanadelumab, con uso limitado de concentrados de C1-INH y ausencia de berotralstat. Aunque el sistema de salud p\u00fablico otorga cobertura del tratamiento, persisten las barreras relacionadas con disponibilidad y costos, lo que condicion\u00f3 el acceso efectivo y la continuidad terap\u00e9utica. Las gu\u00edas cl\u00ednicas fueron consideradas altamente aplicables; no obstante, se identific\u00f3 una brecha entre el tratamiento recomendado y el factible en la pr\u00e1ctica cotidiana.\nCONCLUSIONES: El tratamiento profil\u00e1ctico de pacientes con angioedema hereditario en M\u00e9xico refleja avances cl\u00ednicos relevantes y un enfoque alineado con est\u00e1ndares contempor\u00e1neos; sin embargo, persisten limitaciones estructurales que restringen la implementaci\u00f3n sostenida e individualizada de la profilaxis. Entre las \u00e1reas prioritarias se incluyen el fortalecimiento del diagn\u00f3stico oportuno, el aseguramiento del acceso continuo a terapias dirigidas y la estandarizaci\u00f3n del seguimiento cl\u00ednico.\nPALABRAS CLAVE: Angioedema hereditario; Morbilidad; Calidad de vida; Atenci\u00f3n m\u00e9dica; Opini\u00f3n de expertos; Profilaxis a largo plazo; Inhibidor de C1; Lanadelumab; Berotralstat; M\u00e9xico.<\/jats:p>","DOI":"10.29262\/ram.v73i1.1584","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:42:00Z","timestamp":1774924920000},"page":"93-104","source":"Crossref","is-referenced-by-count":0,"title":["&lt;b&gt;Consenso de expertos mexicanos acerca de la profilaxis a largo plazo en pacientes con angioedema hereditario en M\u00e9xico&lt;\/b&gt;","&lt;b&gt;Consensus of Mexican experts on long-term prophylaxis in patients with hereditary angioedema in Mexico&lt;\/b&gt;"],"prefix":"10.29262","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1675-3894","authenticated-orcid":false,"given":"Guillermo Arturo","family":"Guidos Fogelbach","sequence":"first","affiliation":[{"name":"Instituto Polit\u00e9cnico Nacional, SEPI\/ENMH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5215-1906","authenticated-orcid":false,"given":"Andrea Aida","family":"Velasco Medina","sequence":"additional","affiliation":[{"name":"Hospital General de M\u00e9xico, \u201cDr. Eduardo Liceaga\u201d. Ciudad de M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7489-2177","authenticated-orcid":false,"given":"Freya Helena","family":"Campos Romero","sequence":"additional","affiliation":[{"name":"Hospital Central Sur de Alta Especialidad, Ciudad de M\u00e9xico, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-4477","authenticated-orcid":false,"given":"Mar\u00eda Isabel","family":"Rojo Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Profesora de la Universidad Tecnol\u00f3gica M\u00e9xico, Ciudad de M\u00e9xico, M\u00e9xico. Presidente de la Sociedad Latinoamericana de Alergia, Asma e Inmunolog\u00eda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0793-8312","authenticated-orcid":false,"given":"Sandra Agustina","family":"Nieto Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Unidad de Gen\u00e9tica de la Nutrici\u00f3n, Instituto Nacional\u00a0de Pediatr\u00eda, Ciudad de M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8359-3790","authenticated-orcid":false,"given":"Ileana Mar\u00eda","family":"Madrigal Beas","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Especialidades del CMNO,\u00a0IMSS, Guadalajara, Jalisco, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9863-4196","authenticated-orcid":false,"given":"Jos\u00e9 Jes\u00fas","family":"L\u00f3pez Tiro","sequence":"additional","affiliation":[{"name":"Hospital Regional Licenciado Adolfo L\u00f3pez Mateos\u00a0del ISSSTE, Ciudad de M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3259-0626","authenticated-orcid":false,"given":"Antonio","family":"Albarr\u00e1n God\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital\u00a0General de M\u00e9xico, \u201cDr. Eduardo Liceaga\u201d. Ciudad\u00a0de M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6620-6322","authenticated-orcid":false,"given":"Maria Eugenia","family":"Vargas Cama\u00f1o","sequence":"additional","affiliation":[{"name":"Centro\u00a0M\u00e9dico Nacional 20 de Noviembre, Ciudad de\u00a0M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-2790","authenticated-orcid":false,"given":"Juan Jos\u00e9","family":"Matta Campos","sequence":"additional","affiliation":[{"name":"Centro\u00a0M\u00e9dico Nacional Siglo XXI, IMSS. Ciudad de\u00a0M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-3614","authenticated-orcid":false,"given":"Blanca Mar\u00eda del Refugio","family":"Morfin Maciel","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Pediatr\u00eda, Hospital San \u00c1ngel Inn Chapultepec, Ciudad de M\u00e9xico, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2569-2695","authenticated-orcid":false,"given":"Eduardo Enrique","family":"Pi\u00f1eyro Beltr\u00e1n","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de ISSSTE Especialidades Dr. Pedro B\u00e1rcena\u00a0Hiriart, San Luis Potos\u00ed, SLP, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"67031","doi-asserted-by":"crossref","unstructured":"1. Busse PJ, Christiansen SC. Hereditary angioedema. N Engl J Med 2020; 382: 1136-1148. doi:10.1056\/NEJMra1808012","DOI":"10.1056\/NEJMra1808012"},{"key":"67032","doi-asserted-by":"crossref","unstructured":"2. Maurer M, Magerl M, Betschel S, et al. The international WAO\/EAACI guideline for the management of hereditary angioedema\u20142021 revision and update. Allergy 2022; 77: 1961-1990. doi:10.1111\/all.15214","DOI":"10.1111\/all.15214"},{"key":"67033","doi-asserted-by":"crossref","unstructured":"3. Kaplan AP, Joseph K. Pathogenesis of hereditary angioedema: the role of the bradykinin-forming cascade. Immunol Allergy Clin North Am 2017; 37:513-525. doi: 10.1016\/j.iac.2017.04.001","DOI":"10.1016\/j.iac.2017.04.001"},{"key":"67034","doi-asserted-by":"crossref","unstructured":"4. Wilkerson RG, Moellman JJ. Hereditary angioedema. Immunol Allergy Clin North Am 2023; 43: 533-552. doi: 10.1016\/j.iac.2022.10.012","DOI":"10.1016\/j.iac.2022.10.012"},{"key":"67035","doi-asserted-by":"crossref","unstructured":"5. Li HH. Hereditary angioedema: long-term prophylactic treatment. Allergy Asthma Proc 2020; 41 (Suppl 1): S35-S37. doi:10.2500\/aap.2020.41.200092","DOI":"10.2500\/aap.2020.41.200092"},{"key":"67036","doi-asserted-by":"crossref","unstructured":"6. Longhurst HJ, Valerieva A. A review of randomized controlled trials of hereditary angioedema long-term prophylaxis with C1 inhibitor replacement therapy. J Asthma Allergy 2023; 16: 269-277. doi:10.2147\/JAA.S396338","DOI":"10.2147\/JAA.S396338"},{"key":"67037","doi-asserted-by":"crossref","unstructured":"7. Weller K, Groffik A, Magerl M, et al. Development and construct validation of the angioedema quality of life questionnaire. Allergy 2012; 67: 1289-1298. doi:10.1111\/all.12007","DOI":"10.1111\/all.12007"},{"key":"67038","doi-asserted-by":"crossref","unstructured":"8. Chong-Neto HJ. Quality of life in hereditary angioedema patients: a narrative review. World Allergy Organ J 2023; 16: 100758. doi: 10.1016\/j.waojou.2023.100758","DOI":"10.1016\/j.waojou.2023.100758"},{"key":"67039","doi-asserted-by":"crossref","unstructured":"9. Nieto S, Madrigal I, Contreras F, Vargas ME. Real-world experience of hereditary angioedema in Mexico. World Allergy Organ J 2023; 16: 100812. doi: 10.1016\/j.waojou.2023.100812","DOI":"10.1016\/j.waojou.2023.100812"},{"key":"67040","doi-asserted-by":"crossref","unstructured":"10. Vargas-Cama\u00f1o ME, Buend\u00eda-L\u00f3pez YO, Garc\u00e9s-Flores H, Guzm\u00e1n-V\u00e1zquez S. Hereditary angioedema: patient journey approach in Mexico. Rev Alerg Mex 2023; 70: 121-128. doi:10.29262\/ram. v70i3.1250","DOI":"10.29262\/ram.v70i3.1250"},{"key":"67041","doi-asserted-by":"crossref","unstructured":"11. Yong PFK, Annals R, Diwakar L, et al. Prophylaxis in hereditary angioedema: a United Kingdom Delphi consensus. Clin Exp Immunol 2024; 217: 109-116. doi:10.1093\/cei\/uxae020","DOI":"10.1093\/cei\/uxae020"},{"key":"67042","doi-asserted-by":"crossref","unstructured":"12. Martinez-Saguer I, Dominas N, Straben U, et al. Patients with hereditary angioedema and their treatment patterns in Germany: a Delphi consensus study. Eur J Dermatol 2022; 32: 487-494. doi:10.1684\/ejd.2022.4272","DOI":"10.1684\/ejd.2022.4272"},{"key":"67043","doi-asserted-by":"crossref","unstructured":"13. Tachdjian R, Johnson KE, Casso D, et al. Real-world cohort study of adult and pediatric patients treated for hereditary angioedema in the United States. Allergy Asthma Proc 2020; 41: 172-182. doi:10.2500\/aap.2020.41.200011","DOI":"10.2500\/aap.2020.41.200011"},{"key":"67044","doi-asserted-by":"crossref","unstructured":"14. Riedl MA, Banerji A, Manning ME, et al. Treatment patterns and healthcare resource utilization among patients with hereditary angioedema in the United States. Orphanet J Rare Dis 2018; 13: 180. doi:10.1186\/s13023-018-0922-3","DOI":"10.1186\/s13023-018-0922-3"},{"key":"67045","doi-asserted-by":"crossref","unstructured":"15. Riedl MA, Hinds DR, Prince PM, et al. Healthcare utilization of patients with hereditary angioedema treated with lanadelumab and subcutaneous C1-inhibitor concentrate. Allergy Asthma Proc 2023; 44: 275-282. doi:10.2500\/aap.2023.44.230026","DOI":"10.2500\/aap.2023.44.230026"},{"key":"67046","doi-asserted-by":"crossref","unstructured":"16. Princic N, Evans KA, ShAEH CH, et al. Comparison of real-world healthcare resource utilization and costs among patients with hereditary angioedema on lanadelumab or berotralstat long-term prophylaxis. J Comp Eff Res 2025; 14: e240205. doi:10.57264\/cer-2024-0205","DOI":"10.57264\/cer-2024-0205"},{"key":"67047","doi-asserted-by":"crossref","unstructured":"17. Aberer W, Altrichter S, Cerpes U, et al. Hereditary angioedema due to C1-inhibitor deficiency: a national disease management programme. Wien Klin Wochenschr 2023;135 (Suppl 8):785-798. doi:10.1007\/s00508-023-02298-x","DOI":"10.1007\/s00508-023-02298-x"},{"key":"67048","doi-asserted-by":"crossref","unstructured":"18. Zuraw BL, Lopez-Gonzalez L, Manjelievskaia J, et al. Adherence and persistence among patients with hereditary angioedema receiving long-term prophylaxis in the United States. Allergy Asthma Proc 2025; 46: 209-217. doi:10.2500\/aap.2025.46.250029","DOI":"10.2500\/aap.2025.46.250029"},{"key":"#cr-split#-67049.1","doi-asserted-by":"crossref","unstructured":"19. Donadoni M, La Cava L, Bizzi E, et al. Hereditary angioedema prophylaxis therapy: berotralstat and lanadelumab safety profile. Medicina (Kaunas) 2025","DOI":"10.3390\/medicina61111897"},{"key":"#cr-split#-67049.2","doi-asserted-by":"crossref","unstructured":"61: 1897. doi:10.3390\/medicina61111897","DOI":"10.3390\/medicina61111897"},{"key":"67050","doi-asserted-by":"crossref","unstructured":"20. Walsh S, Bartlett M, Salvo-Halloran EM, et al. Network meta-analysis of pharmacological therapies for long-term prophylactic treatment of patients with hereditary angioedema. Drugs R D 2025; 25: 161-178. doi:10.1007\/s40268-025-00511-y","DOI":"10.1007\/s40268-025-00511-y"},{"key":"67051","doi-asserted-by":"crossref","unstructured":"21. Beard N, Frese M, Smertina E, et al. Interventions for the long-term prevention of hereditary angioedema attacks. Cochrane Database Syst Rev 2022; 11: CD013403. doi: 10.1002\/14651858.CD013403.pub2","DOI":"10.1002\/14651858.CD013403.pub2"},{"key":"67052","doi-asserted-by":"crossref","unstructured":"22. WAEHn V, Aberer W, Ayg\u00f6ren-P\u00fcrs\u00fcn E, et al. Hereditary angioedema in children and adolescents: a consensus update on therapeutic strategies. Pediatr Allergy Immunol 2020; 31: 974-989. doi:10.1111\/pai.13309","DOI":"10.1111\/pai.13309"},{"key":"67053","doi-asserted-by":"crossref","unstructured":"23. WAEHn V, Aberer W, Eberl W, et al. Hereditary angioedema in children and adolescents: a consensus on therapeutic strategies. Eur J Pediatr 2012; 171: 1339-1348. doi:10.1007\/s00431-012-1726-4","DOI":"10.1007\/s00431-012-1726-4"},{"key":"67054","doi-asserted-by":"crossref","unstructured":"24. Frank MM, Zuraw B, Banerji A, et al. Management of children with hereditary angioedema due to C1 inhibitor deficiency. Pediatrics 2016; 138: e20160575. doi:10.1542\/peds.2016-0575","DOI":"10.1542\/peds.2016-0575"},{"key":"67055","doi-asserted-by":"crossref","unstructured":"25. Lumry WR. Hereditary angioedema: the economics of treatment of an orphan disease. Front Med (Lausanne) 2018; 5: 22. doi:10.3389\/fmed.2018.00022","DOI":"10.3389\/fmed.2018.00022"},{"key":"67056","unstructured":"26. Bernstein JA. Severity of hereditary angioedema, prevalence, and diagnostic considerations. I am J Manag Care 2018; 24 (Suppl 14): S292-S298."},{"key":"67057","doi-asserted-by":"crossref","unstructured":"27. Bellanti JA, Settipane RA. From burden to breakthrough: Advances in hereditary angioedema, drug allergy, and allergic disease prevention. Allergy Asthma Proc 2025; 46 (3): 161-164. doi:10.2500\/aap.2025.46.250030","DOI":"10.2500\/aap.2025.46.250030"}],"container-title":["Revista Alergia M\u00e9xico"],"original-title":[],"link":[{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1584\/2852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1584\/2853","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1584\/2885","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1584\/2852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T20:57:04Z","timestamp":1776718624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1584"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3,30]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v73i1.1584","relation":{},"ISSN":["2448-9190","0002-5151"],"issn-type":[{"value":"2448-9190","type":"electronic"},{"value":"0002-5151","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}