From: Attenuated androgen discontinuation in patients with hereditary angioedema: a commented case series
Case | Sex | Age, years | AA | Dose prior to discontinuation | Time on AAs prior to discontinuation, years | Reason for discontinuation | Discontinuation strategy |
---|---|---|---|---|---|---|---|
1 | Female | 50 | Danazol | 200 mg QDa | 28 | Side effects at high doses and insufficient control of HAE attacks at lower dose ⦁ Headaches ⦁ Hypertension ⦁ Muscle cramps ⦁ Virilisation ⦁ Weight gain ⦁ Severe breakthrough attacks at lower AA doses | Immediate withdrawal |
2 | Male | 34 | Oxandrolone | 5 mg QDb | 1.5 | Side effects and insufficient control of HAE attacks ⦁ Polycythaemia | Immediate withdrawal |
3 | Male | 52 | Danazol | 200 mg QDa | 26 | Side effects ⦁ Headaches ⦁ Hypertension ⦁ Myalgia ⦁ Weight gain | Reduced to 100 mg QD for 2 weeks, then 100 mg QOD for 2 weeks, and finally 100 mg/week for 2 weeks, at the same time as 1,000 U pdC1-INH twice/week was introduced |
4 | Male | 76 | Danazol | 300 mg QDa | 18 | Side effects and contraindications ⦁ Treated with angiotensin converting enzyme (ACE) inhibitors and statins, the latter of which resulted in rhabdomyolysis and acute kidney failure ⦁ Hypertension and high blood cholesterol | Immediate withdrawal |
5 | Female | 64 | Danazol | 150 mg QDc | 14 | Contraindications ⦁ Treatment required for hormone-sensitive breast cancer ⦁ Surgery, radiotherapy and exemestane | Immediate withdrawal |
6 | Male | 31 | Danazol | 200 mg five times/weeka | 13 | Insufficient control of HAE attacks | Maintain danazol 200 mg five times/week for 2 weeks during the introduction of lanadelumab 300 mg every 14 days |
7 | Male | 59 | Danazol | 100 mg QDa | 9 | Improved control of HAE attacks and side effects ⦁ Hypercholesterolaemia ⦁ Transaminase elevations, ⦁ Steatosis ⦁ Multifocal leukoencephalopathy | Immediate withdrawal |
8 | Male | 48 | Oxandroloned | 5 mg QD | 15 | Participation in a clinical trial | Immediate withdrawal (2 weeks prior to screening visit for study) |
9 | Female | 43 | Danazol | 100 mg QODa | 29 | Unplanned pregnancy | Immediate withdrawal |
10 | Male | 62 | Danazol | 100 mg QDa | 36 | Loss of access to androgens | Reduced to 100 mg QOD for 1 week, then 100 mg/3 days for 3 weeks |