In affected patients, "activation of the kallikreinkinin cascade leads to uncontrolled generation of plasma kallikrein and consequent proteolysis of high-molecular-weight kininogen. This results in excessive bradykinin production, which causes vasodilation, vascular leakage, and subsequent angioedema and pain," said Aleena Banerji, MD, of Massachusetts General Hospital, Boston, and her associates (N Engl J Med.
Pharmacodynamic assessments showed that lanadelumab inhibited kallikrein in a linear, dose-dependent manner, and the two higher doses reduced levels of cleaved high-molecular-weight kininogen to those reported in healthy controls.
