Title :

Specialist Advice Support for Management of Severe Hereditary Angioedema Attacks: A Multicenter Cluster-Randomized Controlled Trial.

Author(s) :

Javaud, Nicolas [Auteur]
Université Paris 13 [UP13]
Fain, Olivier [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]
Durand-Zaleski, Isabelle [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Launay, David [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Bouillet, Laurence [Auteur]
Gompel, Anne [Auteur]
Sobel, Alain [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Woimant, Maguy [Auteur]
Université Paris 13 [UP13]
Rabetrano, Hasina [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Petrovic, Tomislav [Auteur]
Université Paris 13 [UP13]
Lapostolle, Frederic [Auteur]
Université Paris 13 [UP13]
Boccon-Gibod, Isabelle [Auteur]
Reuter, Paul-Georges [Auteur]
Université Paris 13 [UP13]
Bertrand, Philippe [Auteur]
Université Paris 13 [UP13]
Mezaour, Malha [Auteur]
Université Paris 13 [UP13]
Coppere, Brigitte [Auteur]
Floccard, Bernard [Auteur]
Kanny, Gisele [Auteur]
Baker, Elinor [Auteur]
Université Paris 13 [UP13]
Martin, Ludovic [Auteur]
Université d'Angers [UA]
Vicaut, Eric [Auteur]
Adnet, Frederic [Auteur]
Université Paris 13 [UP13]

Journal title :

Annals of Emergency Medicine

Abbreviated title :

Ann Emerg Med

Volume number :

72

Pages :

194-203.e1

Publication date :

2018-08

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

STUDY OBJECTIVE: Hereditary angioedema is a rare disease associated with unpredictable, recurrent attacks of potentially life-threatening edema. Management of severe attacks is currently suboptimal because emergency ...
Show more >STUDY OBJECTIVE: Hereditary angioedema is a rare disease associated with unpredictable, recurrent attacks of potentially life-threatening edema. Management of severe attacks is currently suboptimal because emergency medical teams are often unaware of new specific treatments. The objective of this trial is to test whether a dedicated national telephone care-management strategy would reduce resource use during severe hereditary angioedema attacks. METHODS: We conducted a cluster-randomized multicenter prospective trial of patients with a documented diagnosis of hereditary angioedema (type I, II or FXII hereditary angioedema). Participants were enrolled between March 2013 and June 2014 at 8 participating reference centers. The randomized units were the reference centers (clusters). Patients in the intervention arm were given a national free telephone number to call in the event of a severe attack. Emergency physicians in the SOS-hereditary angioedema (SOS-HAE) call center were trained to advise or prescribe specific treatments. The primary outcome was number of admissions for angioedema attacks. Economic evaluation was also performed. RESULTS: We included 100 patients in the SOS-HAE group and 100 in the control group. During the 2 years, there were 2,368 hereditary angioedema attacks among 169 patients (85%). Mean number of hospital admissions per patient in the 2-year period was significantly greater in the usual-practice group (mean 0.16 [range 0 to 2] versus 0.03 [range 0 to 1]); patient risk difference was significant: -0.13 (95% confidence interval -0.22 to -0.04; P=.02). Probabilistic sensitivity graphic analysis indicated a trend toward increased quality-adjusted life-years in the SOS-HAE group. CONCLUSION: A national dedicated call center for management of severe hereditary angioedema attacks is associated with a decrease in hospital admissions and may be cost-effective if facilities and staff are available to deliver the intervention alongside existing services.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:08:19Z
2024-03-04T10:56:40Z