Barzilai University Medical Center

11 Research Day 2020 Barzilai University Medical Center 3 CAN HEREDITARY ANGIOEDEMA PATIENTS DISTINGUISH PRODROMES FROM ATTACKS? Iris Leibovich-Nassi 1,2 , Hava Golander 1 , Raz Somech 3 , Dov Har-Even 4 , Avner Reshef 2 1 Department of Nursing, Sackler school of Medicine, Tel Aviv University, 2 Barzilai University Medical Center, Ashkelon, 3 Safra Pediatric Medical Center, Sheba Medical Center, Ramat Gan, 4 Bar- Ilan University, Ramat Gan, Israel. Background Prodromes of Hereditary Angioedema (HAE) are frequently reported, predating the attacks by minutes to several hours. Distinguishing prodromes from attacks enables self-administration and proper timing of treatment administration. Hypothesis Since prodromes predate attacks, experienced patients will be able to tell the difference between the two events. Objectives To investigate the differences and correlations between prodromes and attacks, by using a new validated Patient-reported Outcomes (PRO) instrument. Results We designed and tested a novel questionnaire-based PRO instrument for the evaluation of HAE prodromes and attacks. The high internal content validity and reliability (Cronbach's α= .70 to .98) render it suitable for studying clinical expressions of HAE. 66 HAE patients completed a questionnaire, which addresses five 'clusters' of body systems involved in HAE. This instrument was powered to evaluate if they could distinguish between five major dimensions: location, pain, intensity, impairment and dysfunction. Patients graded their experience in both events on a Likert scale (VAS) of 0-10cm. One-way MANOVA showed significant differences between the clinical dimensions of prodromes and attacks, in all body clusters [F (4, 56) = 45.7, P< .001, Eta 2 =.77]. Patients could distinguish between the two and consider them separately. Additionally, one-way ANOVA for each dimension demonstrated very high differences. For example, differences in abdominal pain [F (1, 59) = 104.1, P< .001, Eta 2 =.64], in the limbs [F (1, 64) = 57.2, P< .001, Eta 2 =.47]. Associations were analyzed by Pearson's coefficient, showing high statistical correlation (i.e. abdominal pain r=.45, p<.001, laryngeal pain r=.46, p>.001). Higher intensity of a prodrome was followed by higher intensity of an attack. Collectively, all dimensions of prodromes were much lower than the attacks. Conclusions We found that patients could discern prodromes from attacks, and describe them accurately by using the questionnaire items. Prodromes and attacks in various locations were associated but also distinguishable.