[Consensus of Mexican experts on long-term prophylaxis in patients with hereditary angioedema in Mexico].

BACKGROUND

Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent, bradykinin-mediated swelling episodes, with substantial impact on morbidity, quality of life, and healthcare resource use. Targeted agents have reshaped long-term prophylaxis (LTP); however, effective implementation depends on clinical decision-making as well as health-system access and structural constraints.

OBJECTIVE

To comprehensively describe HAE long-term prophylaxis management in Mexico, focusing on the diagnostic approach, LTP use, treatment access and availability, perceived disease control, and applicability of clinical recommendations, based on structured national expert opinion.

METHODS

We conducted a descriptive and analytical evaluation of Mexico-specific data derived from a structured Delphi process involving clinicians experienced in HAE management. Assessed domains included diagnostic testing practices, selection and prescribing frequency of LTP therapies, use of non-recommended treatments, funding sources, medication availability issues, access barriers, and clinicians' perceptions regarding disease control and guideline applicability.

RESULTS

Experts reported strong conceptual alignment with current clinical recommendations. LTP prescribing was predominantly concentrated on lanadelumab, with limited use of C1-INH concentrates and no reported use of berotralstat. Despite reported public coverage, frequent barriers related to availability and cost constrained effective access and treatment continuity. Clinical guidelines were perceived as highly applicable; however, a gap between recommended care and feasible real-world implementation was consistently acknowledged.

CONCLUSIONS

HAE prophylaxis management in Mexico appears aligned with contemporary standards, yet sustained and individualized implementation remains limited by structural access and supply constraints. Key priorities include strengthening timely diagnosis, ensuring continuous access to targeted therapies, and standardizing follow-up in routine clinical care.