Delphi Consensus on Attenuated Androgen Use for Long-Term Prophylaxis in Hereditary Angioedema: AURA Project

    November 2025 in “ Clinical and Translational Allergy ”
    Eunice Dias de Castro, Luís Cardoso, João Jácome de Castro, Manuel Branco Ferreira
    Studysummary This study developed a consensus document to guide danazol discontinuation in hereditary angioedema patients, enhancing the standardization and safety of treatment protocols. Our plain-language summary of this paper — not a Tressless recommendation.
    The Delphi Consensus on Attenuated Androgen Use for Long-Term Prophylaxis in Hereditary Angioedema (AURA Project) provides 46 recommendations for the management of danazol, focusing on personalized treatment plans and standardized protocols due to its potential adverse effects. The study involved 23 experts and emphasizes a maximum daily dose of 200 mg, with higher doses only in specific cases. Danazol is recommended as a second-line treatment, with absolute contraindications including pregnancy and cancer. Regular monitoring is crucial, particularly for signs of virilization and liver health. The consensus encourages transitioning to newer, safer therapies like pdC1-INH, lanadelumab, and berotralstat, while addressing accessibility and cost challenges.
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