Berinert (C1 Esterase Inhibitor, human)

Berinert (C1 Esterase Inhibitor, human) Uses, Dosage, Side Effects, Food Interaction and all others data.

C1 Esterase Inhibitor (Recombinant) is a recombinant analogue of endogenous complement component-1 esterase inhibitor (rhC1INH), purified from the milk of transgenic rabbits. The primary function of endogenous C1INH is to regulate the activation of the complement and contact system pathways. It does this through inhibition of several target proteases within these pathways including activated C1s, kallikrein, factor XIIa and factor XIa. C1 esterase inhibitor has also been shown to inhibit the action of thrombin within the coagulation pathway, and tPA and plasmin within the fibrinolytic pathway. Deficiency of C1-inhibitor allows for increased plasma kallikrein activation and subsequent production of bradykinin. Additionally, C4 and C2 cleavage occurs resulting in auto-activation of the complement system. Down-stream effects of the lack of enzyme inhibition by C1 esterase inhibitor results in swelling due to leakage of fluid from blood vessels into connective tissue and consequently the presentation of hereditary angioedema (HAE).

Marketed as the product Ruconest (FDA), this drug is indicated for the treatment of acute attacks of hereditary angioedema (HAE) due to C1 esterase inhibitor deficiency in adults. Intravenous replacement of C1 esterase inhibitor results in reversal of acute symptoms of HAE.

A dose of 50 U/kg of Ruconest increases plasma C1INH activity levels to greater than 0.7 U/mL (the lower limit of normal) in HAE patients.

Trade Name Berinert (C1 Esterase Inhibitor, human)
Generic Conestat alfa
Conestat alfa Other Names C1 Esterase Inhibitor (Recombinant), C1 Inhibitor (Recombinant), Complement C1 esterase inhibitor, Conestat alfa, Human C1-inhibitor (recombinant, rabbit derived), Recombinant complement C1 esterase inhibitor, Recombinant human C1 inhibitor, Recombinant human C1-inhibitor, Recombinant human C1-inhibitor rabbit milk derived
Type
Weight 67000.0 Da
Groups Approved, Investigational
Therapeutic Class
Manufacturer
Available Country Australia, Austria, Belgium, Bulgaria, Canada, Cyprus, Denmark, Finland, France, Germany, Greece, Hungary, Israel, Italy, Malta, Norway, Poland, Russia, Sweden, Switzerland, United Kingdom
Last Updated: September 19, 2023 at 7:00 am
Berinert (C1 Esterase Inhibitor, human)
Berinert (C1 Esterase Inhibitor, human)

Uses

Berinert (C1 Esterase Inhibitor, human) is a recombinant C1INH used for the treatment of acute attacks of hereditary angioedema (HAE) due to C1 esterase inhibitor deficiency in adults.

For the treatment of acute attacks of hereditary angioedema (HAE) due to C1 esterase inhibitor deficiency in adults.

Berinert (C1 Esterase Inhibitor, human) is also used to associated treatment for these conditions: Acute attack of hereditary angioedema

How Berinert (C1 Esterase Inhibitor, human) works

The primary function of endogenous C1INH is to regulate the activation of the complement and contact system pathways. It does this through inhibition of several target proteases within these pathways including activated C1s, kallikrein, factor XIIa and factor XIa. C1 esterase inhibitor has also been shown to inhibit the action of thrombin within the coagulation pathway, and tPA and plasmin within the fibrinolytic pathway. Deficiency of C1-inhibitor allows increased plasma kallikrein activation and subsequent production of bradykinin. Additionally, C4 and C2 cleavage is no longer inhibited allowing auto-activation of the complement system. Down-stream effects of the lack of enzyme inhibition by C1 esterase inhibitor results in swelling due to leakage of fluid from blood vessels into connective tissue and consequently the presentation of hereditary angioedema (HAE). Replacement of C1 esterase inhibitor results in a reversal of these effects.

Toxicity

The common adverse reactions (≥ 2%) reported in clinical trials were headache, nausea, and diarrhea.

Serious arterial and venous thromboembolic (TE) events have been reported at the recommended dose of plasma derived C1 esterase inhibitor products in patients with risk factors. Risk factors may include the presence of an indwelling venous catheter/access device, prior history of thrombosis, underlying atherosclerosis, use of oral contraceptives or certain androgens, morbid obesity, and immobility. Monitor patients with known risk factors for TE events during and after administration.

Food Interaction

No interactions found.

Elimination Route

Mean Cmax was found to be 1.2 U/mL and Tmax was 0.31 ± 0.10 hr following administration of 50 U/kg.

Clearance

Clearance was found to be 1207 ± 414 mL/hr following administration of 50 U/kg.

Elimination Route

Elimination half-life was approximately 2.5 hours.

Innovators Monograph

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