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. 2022 Nov 3;2022(11):CD013403. doi: 10.1002/14651858.CD013403.pub2

Summary of findings 2. Berotralstat compared with placebo or active control for preventing hereditary angioedema attacks.

Berotralstat compared with placebo or active control for preventing HAE attacks
Patient or population: children or adults with Types I or II HAE
Settings: outpatient setting
Intervention: berotralstat
Comparison: placebo
Outcomes Anticipated absolute effects* (95% CI) Relative effect
(95% CI) No of participants
(studies) Certainty of the evidence
(GRADE) Comments
Risk with placebo Risk with berotralstat
Risk of HAE attacks
(during follow‐up)
Study population RR 0.63 (0.39 to 1.00) 37
(1)
⊕⊕⊝⊝
Lowa
910 per 1000 573 per 1000 (355 to 910)
Change in number of HAE attacks
(per week)
Study population 130
(3)
⊕⊕⊝⊝
Lowa
The number of HAE attacks per week ranged across control groups from 0.55 to 0.95 The number of HAE attacks per week in the intervention groups was 0.39 attacks lower (0.74 lower to 0.05 lower)
Mortality
(during follow‐up)
Study population N/A N/A N/A No deaths reported.
N/A N/A
Serious adverse events
(during follow‐up)
Study population RR 0.77 (0.02 to 24.03) 128
(3) ⊕⊕⊝⊝
Lowa
45 per 1000 35 per 1000 (1 to 1000)
Quality of life
Angioedema Quality of Life scale
(lower score is better)
(during follow‐up) Study population 130
(3)
⊕⊕⊕⊝
Moderateb
The mean change in quality of life ranged across control groups from 3.18 points to −9.69 points The mean change in quality of life in the intervention group was 15.28 points lower (29.42 lower to 1.14 lower)
Disability
Standardised mean difference
(lower is better)
(during follow‐up)
Study population 50
(2)
⊕⊕⊝⊝
Lowa
The mean change in disability ranged across control groups from 1.51 to −1.95 The mean change in disability in the intervention groups was 1.01 units lower (1.62 lower to 0.40 lower)
Adverse events
(during follow‐up) Study population RR 1.03 (0.88 to 1.22) 128
(3)
⊕⊕⊕⊝
Moderateb
761 per 1000 784 per 1000 (670 to 1000)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; HAE: hereditary angioedema; N/A: not applicable; RR: risk ratio.
GRADE Working Group grades of evidenceHigh certainty: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: we are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.
Very low certainty: we have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.

aDowngraded two levels for imprecision.
bDowngraded one level for imprecision.