On June 16, 2025, the U.S. Food and Drug Administration (FDA) approved Andembry® (garadacimab-gxii) for the prevention of attacks of hereditary angioedema (HAE) in patients 12 years and older. Andembry® is the first and only medication that works to prevent attacks of HAE by targeting factor XIIa, an enzyme involved in various systems of the body associated with blood clotting and inflammation. Blocking factor Xlla prevents HAE attacks by inhibiting the onset of the cascade of inflammation and swelling. HAE is a rare and serious genetic disease, occurring in approximately 1 in 50,000 individuals in the United States, and involves recurrent attacks of swelling that can involve the face, hands, feet, as well as internal organs, including the gastrointestinal tract and airway. HAE attacks involving the airway can be life-threatening due to swelling and breathing restriction, which can lead to suffocation. Various triggers can set off an HAE attack, such as stress or illness.
Andembry® is a monoclonal antibody designed to mimic the body’s own natural proteins. The subcutaneous (under the skin) injection may be self-administered, after proper instruction from a health care provider. An initial loading dose of 400mg is recommended, followed by a maintenance dose of 200mg once a month. Andembry® was evaluated for safety and efficacy in a phase 3 placebo-controlled study, called VANGUARD. Of the 64 patients enrolled in the six-month trial, 62% experienced zero HAE attacks during the treatment period, and Andembry® significantly reduced HAE attacks by 89% compared to treatment with placebo. Side effects of Andembry® include redness, itching, bruising at the injection site, stomach pain, runny or stuffy nose, sneezing and watery eyes.