Name of the Procedure:

Injection of C-1 Esterase Inhibitor (Human), commonly known as Berinert Injection (HCPCS code J0597).

Summary

This procedure involves the administration of Berinert, a concentrated solution of C1 esterase inhibitor derived from human plasma. It is used to treat hereditary angioedema (HAE), a genetic condition that causes sudden and severe swelling in various parts of the body.

Purpose

Berinert injections aim to:

• Rapidly alleviate the acute symptoms of hereditary angioedema.
• Prevent the recurrence of swelling episodes, resulting in enhanced quality of life and reduced frequency of emergency care.

Indications

• Specifically indicated for patients diagnosed with hereditary angioedema.
• Effective for treating severe swelling, abdominal pain, and airway obstruction related to HAE.

Preparation

• No special fasting requirements.
• Patients should inform their healthcare provider about any medications they are taking, as some may need adjustment.
• Baseline blood tests or allergy assessments may be necessary to ensure suitability.

Procedure Description

1. Pre-Procedure Assessment: Confirm diagnosis and suitability for Berinert therapy.
2. Preparation of Injection Site: Clean the injection site with an antiseptic.
3. Reconstitution of Berinert: If applicable, mix the powdered Berinert with the provided diluent to form a solution.
4. Injection: Administer the reconstituted Berinert intravenously, usually in a vein in the arm.
   • No general anesthesia is required.
   • The procedure may involve a tiny prick; minor discomfort at the injection site is possible.

Duration

The injection typically takes between 10 to 20 minutes.

Setting

• Generally performed in a hospital setting, outpatient clinic, or specialized infusion center.
• Occasionally administered at home by trained personnel.

Personnel

• A healthcare provider, such as a nurse or physician, administers the injection.
• Support personnel might include medical assistants and, if necessary, a pharmacist for drug preparation.

Risks and Complications

• Common: Mild pain or swelling at the injection site, headache, or fatigue.
• Rare: Allergic reactions, blood clots, or infections. Immediate medical attention is crucial for severe reactions.

Benefits

• Rapid relief from the symptoms of hereditary angioedema.
• Effective onset typically occurs within minutes to an hour post-administration.
• Long-term reduction in the frequency of HAE attacks.

Recovery

• Patients are usually monitored for a short period after the injection to ensure no adverse effects.
• Follow-up care includes routine visits to monitor for recurrence of symptoms.
• Most patients can resume normal activities shortly after the procedure.

Alternatives

• Other treatment options include other brands of C-1 esterase inhibitors, synthetic alternatives, or prophylactic medications.
• Each alternative has its own pros and cons, with varying efficacy, cost, and administration frequency.

Patient Experience

• During the injection, patients might feel a brief prick or mild discomfort.
• Post-injection, some might experience transient tiredness or mild localized pain.

• Pain management is rarely necessary, but over-the-counter pain relievers can provide relief if needed.

  Comfort measures include lying back, hydration, and calm setting during the procedure administration.