Side effects of long-term prophylaxis with attenuated androgens in hereditary angioedema: Comparison of treated and untreated patients

Abstract

Danazol and stanozolol, 17-a-alkylated attenuated androgens, prevent symptoms in hereditary angioedema (HAE), the inherited deficiency of Cl-inhibitor?, 2 Possible side effects can be due to: (1) residual hormonal activity (seborrhoea, acne, increased hair growth, weight gain, deepening of the voice, decreased breast size, vasomotor symptoms, irregular vaginal bleeding, decreased libido), (2) 17c~-alkylation (hepatotoxicity, ranging from signs of necrosis and cholestasis to the induction of hepatocellular and vascular neoplasm), (3) changes in the levels of lipoproteins (possible potentiation of atherogenesis)?. 4 The few reports on the safety of long-term treatment with androgens for prophylaxis of HAE have failed to show important drug-related side effects. 5, 6 However, none of these studies included a control group of untreated patients with HAE. The aim of this study was to compare clinical and biochemical parameters in patients with untreated HAE and in those who had been treated with attenuated androgens for long periods.