{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:23Z","timestamp":1785301403377,"version":"3.55.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hereditary angioedema (HAE) is a rare genetic disorder, characterized by unpredictable, potentially life-threatening edema attacks. Treatment options include on-demand treatment (ODT) and long-term prophylactic (LTP) therapy. This study describes the HAE treatment landscape in Sweden, focusing on the uptake of recently reimbursed modern LTP therapies and patterns of ODT dispensation as an indirect proxy for breakthrough attacks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide, longitudinal, registry-based study utilized data from the National Prescribed Drug Register in Sweden describing all dispensed drugs with approved indications for HAE between January 2020\u2013May 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 2024, 245 patients received HAE-specific drugs, with one-third dispensing LTP. Among patients with \u226512 months on modern LTP (n=69) who had at least one ODT dispensation event during their most recent 12 months of treatment (n=46\/59 for lanadelumab; n=8\/9 for berotralstat), the mean number of ODT packages dispensed\u2014in addition to emergency stock ODT\u2014was 4.3 per patient on lanadelumab and 6.5 per patient on berotralstat. Overall, 22% (n=15\/69) of patients receiving modern LTP did not dispense ODT medication during their most recent 12-months of treatment. In total, 22% of patients (n=24\/108) with at least one lanadelumab or berotralstat dispensation stopped dispensing modern LTP and switched to alternative LTP or ODT-only treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study provides valuable insights into real-world dispensation patterns of HAE drugs in Sweden. Despite the availability of modern LTP therapies, there remains relatively high ODT dispensation events, suggesting ongoing unmet need and underscoring the importance of optimizing prophylactic strategies to achieve total disease control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1828443","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:43:57Z","timestamp":1785300237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The evolving treatment landscape for hereditary angioedema in Sweden"],"prefix":"10.3389","volume":"17","author":[{"given":"Sabrina","family":"Meisgen","sequence":"first","affiliation":[{"name":"CSL Behring AB","place":["Stockholm, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Fischer","sequence":"additional","affiliation":[{"name":"Quantify Research AB","place":["Stockholm, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinglei","family":"Li","sequence":"additional","affiliation":[{"name":"CSL Behring","place":["King of Prussia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/all.15214","article-title":"The international WAO\/EAACI guideline for the management of hereditary angioedema-the 2021 revision and update","volume":"77","author":"Maurer","year":"2022","journal-title":"Allergy"},{"key":"B2","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jaci.2024.03.024","article-title":"Definition, acronyms, nomenclature, and classification of angioedema (DANCE): AAAAI, ACAAI, ACARE, and APAAACI DANCE consensus","volume":"154","author":"Reshef","year":"2024","journal-title":"J Allergy Clin Immunol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1007\/s12016-025-09027-4","article-title":"Hereditary angioedema with normal C1 inhibitor: an updated international consensus paper on diagnosis, pathophysiology, and treatment","volume":"68","author":"Zuraw","year":"2025","journal-title":"Clin Rev Allergy Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2450","DOI":"10.1016\/j.jaip.2023.01.023","article-title":"Hereditary angioedema with normal C1 inhibitor: US survey of prevalence and provider practice patterns","volume":"11","author":"Riedl","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2025.46.240096","article-title":"Management of hereditary angioedema attacks by patients on long-term prophylaxis versus on-demand therapy only","volume":"46","author":"Lumry","year":"2025","journal-title":"Allergy Asthma Proc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s13023-021-01717-4","article-title":"Clinical characteristics and burden of illness in patients with hereditary angioedema: findings from a multinational patient survey","volume":"16","author":"Mendivil","year":"2021","journal-title":"Orphanet J Rare Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0875","article-title":"Expert review and consensus on the treat-to-target management of hereditary angioedema: from scientific evidence to clinical practice","volume":"33","author":"Caballero","year":"2023","journal-title":"J Investig Allergol Clin Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1186\/s13023-025-03739-8","article-title":"Unmet needs in hereditary angioedema: an international survey of physicians","volume":"20","author":"Buttgereit","year":"2025","journal-title":"Orphanet J Rare Dis"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.11.034","article-title":"Trends in treatments with disease-specific and interfering drugs in patients with hereditary angioedema in Sweden","volume":"11","author":"Sundler Bj\u00f6rkman","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B10","unstructured":"The Medical Products Agency's regulations (HSLF - FS 2017:74) on restrictions on the prescription and dispensing of certain medicinal products\n          \n          2017"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2025.46.250029","article-title":"Adherence and persistence among patients with hereditary angioedema receiving long-term prophylaxis in the United States","volume":"46","author":"Zuraw","year":"2025","journal-title":"Allergy Asthma Proc"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s40268-025-00511-y","article-title":"Network meta-analysis of pharmacological therapies for long-term prophylactic treatment of patients with hereditary angioedema","volume":"25","author":"Walsh","year":"2025","journal-title":"Drugs R D"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/14728214.2022.2105834","article-title":"Emerging drugs for the treatment of hereditary angioedema due to C1-inhibitor deficiency","volume":"27","author":"Zanichelli","year":"2022","journal-title":"Expert Opin Emerg Drugs"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)00350-1","article-title":"Efficacy and safety of garadacimab, a factor XIIa inhibitor for hereditary angioedema prevention (VANGUARD): a global, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial","volume":"401","author":"Craig","year":"2023","journal-title":"Lancet"},{"key":"B15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1056\/nejmoa2402478","article-title":"Efficacy and safety of donidalorsen for hereditary angioedema","volume":"391","author":"Riedl","year":"2024","journal-title":"N Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.57264\/cer-2024-0237","article-title":"Matching-adjusted indirect comparison between garadacimab and lanadelumab for the long-term prophylactic treatment of patients with hereditary angioedema","volume":"14","author":"Walsh","year":"2025","journal-title":"J Comp Eff Res"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1828443\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:44:00Z","timestamp":1785300240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1828443\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":16,"alternative-id":["10.3389\/fimmu.2026.1828443"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1828443","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"article-number":"1828443"}}