Mitigating Disparity in Health-care Resources Between Countries for Management of Hereditary Angioedema
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Published:2021-05-18
Issue:1
Volume:61
Page:84-97
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ISSN:1080-0549
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Container-title:Clinical Reviews in Allergy & Immunology
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language:en
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Short-container-title:Clinic Rev Allerg Immunol
Author:
Jindal Ankur KumarORCID, Reshef AvnerORCID, Longhurst HilaryORCID, Aberer Werner, Betchel Stephen, Bork Konrad, Aygören-Pürsün Emel, Maurer Marcus, Magerl Markus, Bouillet Laurence, Bygum Anette, Caballero Teresa, Cancian Mauro, Farkas Henriette, Grivcheva-Panovska Vesna, Grumach Anete, Gulbahar Okan, Hide Michihiro, Jindal Ankur, Singh Surjit, Kang Hye-Ryun, Reshef Avner, Kessel Aharon, Longhurst Hilary, Lindsay Karen, Jordan Anthony, Ameratunga Rohan, Lumry William, Bernstein Jonathan, Craig Timothy, Riedl Marc, Levy Don, Malbran Alejandro, Germenis Anastasios, Psarros Fotis, Stobiecki Marcin, Porebski Grzegorz, Valerieva Anna, Wardman Fiona, Zhong Youjia, Weber Christina,
Abstract
AbstractHereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of skin and mucosal edema. The main treatment goal is to enable a “normal life” for all patients. However, due to high costs, there are limited options for the management of HAE in most developing and low-income countries. As a result, most of the recommended first-line treatments are not available. In this review, we attempt to highlight the disparities in health-care resources for the management of patients with HAE amongst different countries. Data was collected from HAE experts in countries who provide tabulated information regarding management and availability of HAE treatments in their countries. We reviewed the two most recent international HAE guidelines. Using India, the world’s second most populous country, as a paradigm for HAE management in lower-income countries, we reviewed the evidence for second-line and non-recommended practices reported by HAE experts. Results suggest significant inequities in provision of HAE services and treatments. HAE patients in low-income countries do not have access to life-saving acute drugs or recently developed highly effective prophylactic medications. Most low-income countries do not have specialized HAE services or diagnostic facilities, resulting in consequent long delays in diagnosis. Suggestions for optimizing the use of limited resources as a basis for future discussion and reaching a global consensus are provided. There is an urgent need to improve HAE services, diagnostics and treatments currently available to lower-income countries. We recommend that all HAE stakeholders support the need for global equity and access to these essential measures.
Publisher
Springer Science and Business Media LLC
Subject
General Medicine,Immunology and Allergy
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