Oral deucrictibant for on-demand treatment of hereditary angioedema attacks: a phase 3, multicentre, randomised, double-blind, placebo-controlled crossover trial.
Marc A Riedl, Philip H Li, Adil Adatia et al.
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In 30 seconds
RAPIDe-3 was a phase 3, multicentre, randomised, double-blind, placebo-controlled crossover trial of oral deucrictibant for on-demand treatment of hereditary angioedema attacks. It enrolled adolescents and adults aged 12–75 years with hereditary angioedema and recent attacks at 59 sites in 24 countries. Among 88 participants included in the paired primary efficacy analysis, symptom relief began sooner with deucrictibant than placebo: median 1·28 h (95% CI 1·05 to 1·52) versus more than 12 h (5·82 to >12; p<0·0001). Deucrictibant was generally well tolerated.
Key findings
- In the paired efficacy analysis, median time to symptom relief was 1·28 h with deucrictibant versus more than 12 h with placebo (p<0·0001).
- Fatigue was the only adverse event reported more than once within 3 days post-treatment; one of the two events was considered unrelated.
- No treatment-related adverse events were assessed as severe or serious, and no adverse events led to treatment discontinuation.
Why it matters
Hereditary angioedema attacks require on-demand relief, while oral options that provide prompt and sustained benefit remain limited. This trial found substantially faster symptom relief with an oral bradykinin B2 receptor antagonist than with placebo, alongside a generally favourable short-term safety profile. The findings add evidence for an oral approach to attack treatment, although they do not establish comparative effectiveness against other active therapies.
What to keep in mind
The primary efficacy analysis included 88 participants with paired treated attacks, fewer than the 134 randomly allocated. The abstract reports symptom-relief timing and short-term safety, but does not provide comparative results against active on-demand treatments.