What is Lanadelumab: Uses, Dosage, Side Effects and More

Lanadelumab is a prescription medication specifically designed to prevent attacks of hereditary angioedema (HAE), a rare genetic condition that causes sudden swelling in various parts of your body. This injectable medicine works by blocking a protein called kallikrein, which triggers the swelling episodes that can be both painful and potentially dangerous.

If you or someone you love has been diagnosed with HAE, you're likely feeling overwhelmed by the complexity of managing this condition. The good news is that lanadelumab represents a significant breakthrough in HAE treatment, offering many people the chance to live with fewer attacks and greater peace of mind.

What is Lanadelumab?

Lanadelumab is a monoclonal antibody medication that belongs to a class of drugs called kallikrein inhibitors. Think of it as a targeted treatment that works like a specialized security guard in your body, specifically watching for and blocking the protein that causes HAE attacks.

This medication comes as a clear liquid that you inject under your skin (subcutaneously) using a pre-filled syringe. The drug is also known by its brand name Takhzyro, and it's manufactured using advanced biotechnology to create a highly specific treatment for HAE.

What makes lanadelumab unique is its precision. Instead of broadly suppressing your immune system like some other medications, it targets only the specific pathway that causes HAE attacks, leaving the rest of your immune function intact.

What is Lanadelumab Used For?

Lanadelumab is FDA-approved specifically for preventing attacks of hereditary angioedema in adults and adolescents 12 years and older. HAE is a genetic condition where your body doesn't properly regulate a protein called C1 esterase inhibitor, leading to episodes of severe swelling.

During an HAE attack, you might experience sudden swelling in your face, lips, tongue, throat, hands, feet, or genitals. These episodes can be unpredictable and vary in severity. Some attacks might cause mild discomfort, while others can be life-threatening if they involve your airway.

The medication is designed for long-term prevention, not for treating an attack that's already happening. If you're having an acute HAE attack, you'll need different emergency medications that work quickly to stop the swelling.

Your doctor might recommend lanadelumab if you're experiencing frequent HAE attacks that significantly impact your quality of life, work, or daily activities. The goal is to reduce both the frequency and severity of these episodes.

How Does Lanadelumab Work?

Lanadelumab works by blocking plasma kallikrein, a protein that plays a key role in the cascade of events leading to HAE attacks. When this protein is active, it triggers the production of bradykinin, a substance that causes blood vessels to become leaky and leads to the characteristic swelling of HAE.

By inhibiting kallikrein, lanadelumab essentially stops this chain reaction before it can cause symptoms. The medication binds to kallikrein and prevents it from doing its job, which significantly reduces the likelihood of an attack occurring.

This is considered a moderately strong and highly targeted medication. Unlike some treatments that broadly affect your immune system, lanadelumab is designed to be very specific in its action, which generally means fewer side effects and interactions with other body systems.

The effects of lanadelumab build up over time, which is why it's important to take it regularly as prescribed. Most people start to notice a reduction in attack frequency within the first few months of treatment.

How Should I Take Lanadelumab?

Lanadelumab is given as a subcutaneous injection, which means you inject it into the fatty tissue just under your skin. The standard dose is 300 mg every two weeks, though your doctor might adjust this based on how well you respond to treatment.

You can inject lanadelumab into your thigh, upper arm, or abdomen. It's important to rotate injection sites to prevent skin irritation or the development of hard lumps under the skin. Your healthcare provider will teach you or a family member how to give these injections safely at home.

Before injecting, take the medication out of the refrigerator and let it reach room temperature for about 15-20 minutes. Cold medication can be more uncomfortable to inject. Always check that the liquid is clear and colorless before using it.

You can take lanadelumab with or without food, since it's injected rather than taken by mouth. However, it's helpful to establish a routine, such as injecting it on the same days of the week, to help you remember your doses.

How Long Should I Take Lanadelumab For?

Lanadelumab is typically intended for long-term use, as HAE is a chronic genetic condition that requires ongoing management. Most people continue taking this medication indefinitely to maintain protection against attacks.

Your doctor will monitor your response to treatment over the first few months and may adjust the dosing schedule based on how well you're doing. Some people who have very good control of their symptoms might eventually be able to space out their injections to every four weeks instead of every two weeks.

It's important not to stop taking lanadelumab suddenly without talking to your doctor first. Since the medication works by maintaining steady levels in your system, stopping abruptly could lead to a return of HAE attacks.

Your healthcare provider will regularly review your treatment plan and assess whether lanadelumab continues to be the best option for you. They'll consider factors like attack frequency, side effects, and your overall quality of life.

What Are the Side Effects of Lanadelumab?

Like all medications, lanadelumab can cause side effects, though many people tolerate it well. The most common side effects are generally mild and occur at the injection site.

Here are the most frequently reported side effects that you might experience:

• Injection site reactions including redness, swelling, bruising, or pain
• Upper respiratory tract infections like colds
• Headaches
• Dizziness
• Rash or skin irritation

These common side effects usually improve on their own and don't require stopping the medication. Proper injection technique and site rotation can help minimize injection site reactions.

There are also some less common but more serious side effects that require immediate medical attention. While these are rare, it's important to be aware of them:

• Severe allergic reactions including difficulty breathing, swelling of face or throat, or widespread rash
• Signs of serious infection such as fever, chills, or persistent flu-like symptoms
• Unusual bleeding or bruising
• Severe or persistent headaches

Most people find that any side effects they experience are manageable and much less disruptive than the HAE attacks they were having before treatment.

Who Should Not Take Lanadelumab?

Lanadelumab isn't appropriate for everyone, and there are certain situations where your doctor might recommend a different treatment approach. The most important contraindication is if you've had a severe allergic reaction to lanadelumab or any of its ingredients in the past.

Your doctor will carefully evaluate whether lanadelumab is right for you if you have any of these conditions:

• Active serious infections
• Severe liver or kidney disease
• A history of severe allergic reactions to other monoclonal antibody medications
• Pregnancy or plans to become pregnant
• Breastfeeding

Special consideration is also needed for people with autoimmune conditions, as lanadelumab affects immune system function. Your doctor will weigh the benefits against potential risks in these situations.

Age is another important factor. Lanadelumab is only approved for people 12 years and older, as there isn't enough safety and effectiveness data for younger children.

Lanadelumab Brand Name

Lanadelumab is marketed under the brand name Takhzyro. This is the name you'll see on the prescription label and packaging when you pick up your medication from the pharmacy.

Takhzyro is manufactured by Takeda Pharmaceuticals and was first approved by the FDA in 2018. The medication comes in pre-filled syringes containing 150 mg of lanadelumab in 1 mL of solution.

Currently, there are no generic versions of lanadelumab available, as the medication is still under patent protection. This means Takhzyro is the only brand name version you can get.

Lanadelumab Alternatives

While lanadelumab is highly effective for many people with HAE, it's not the only treatment option available. Your doctor might consider alternatives if lanadelumab doesn't work well for you or if you experience intolerable side effects.

Other preventive medications for HAE include:

• Berotralstat (Orladeyo) - an oral medication taken daily
• C1 esterase inhibitor concentrates given by IV infusion
• Danazol - an oral medication that's been used for decades
• Tranexamic acid - an oral medication that can help some people

Each of these alternatives has different benefits and drawbacks. For example, berotralstat offers the convenience of daily oral dosing, while C1 esterase inhibitor concentrates replace the protein that's deficient in HAE.

Your doctor will help you weigh factors like effectiveness, side effects, convenience, and cost when choosing the best treatment for your specific situation.

Is Lanadelumab Better Than Berotralstat?

Both lanadelumab and berotralstat are effective modern treatments for HAE prevention, but they work in different ways and have different advantages. The "better" choice depends on your individual needs, preferences, and medical situation.

Lanadelumab is given as an injection every two weeks, while berotralstat is taken as a daily oral capsule. Some people prefer the convenience of not having to remember daily medication, while others prefer avoiding injections.

In terms of effectiveness, both medications significantly reduce HAE attack rates for most people. Clinical studies show that lanadelumab reduces attack rates by about 87% on average, while berotralstat reduces them by about 44%. However, individual responses can vary significantly.

Side effect profiles also differ between the two medications. Lanadelumab's main side effects are injection site reactions, while berotralstat can cause gastrointestinal symptoms like nausea and abdominal pain in some people.

Your doctor will consider your attack frequency, lifestyle, other medications you're taking, and personal preferences when helping you choose between these options.