Female doctors talking to elderly male patient

Alpha-1 Antitrypsin Deficiency

The clinical effects of alpha-1 antitrypsin deficiency (AATD) are highly variable and are dependent on genotype, phenotype and exposure to risk factors such as smoking and pollution.1,2

AATD is a genetic condition associated with low protein levels of functional alpha-1 proteinase inhibitor (A1PI).2,3

The main clinical manifestations involve the lungs, leading to emphysema, and the liver, but it can also be associated with other skin and cardiovascular disorders.3,4,5

Respiratory system anatomical diagram with lung highlight

Pathophysiology

AATD is caused by a mutation in the SERPINA1 gene on chromosome 14 encoding for A1PI.6 Each person has two alleles (variants) of the gene, one inherited from each parent where the most common ones are:5

  • M allele— results in normal levels of functional A1PI6,7
  • S allele—  expresses approximately 50 to 60% normal A1PI where the variant is unstable and easily degrades8,9
  • Z allele—  expresses approximately 10 to 20% of normal A1PI due to much of the A1PI accumulating in the liver8,9


A1PI is primarily synthesized in the liver and secreted into the bloodstream where it diffuses into the lungs and other tissues.2,8,10  The main role of A1PI is to inhibit neutrophil elastase (NE) and keep its activity in check.2,10 NE is a proteinase responsible for the breakdown of a variety of proteins involved in modulating inflammation and therefore plays a key role in tissue repair and protection from infections.11 Therefore, a deficiency in functional A1PI results in excessive NE activity and leads to the degradation of lung tissue and blood vessels.12

Epidemiology

The prevalence of AATD varies by genotype with an estimated 3.4 million people living with the disease worldwide (protease inhibitor [Pi] SS, PiSZ, PiZZ) and 116 million carriers (PiMS, PiMZ).2,13 In the U.S., it’s estimated that more than 500,000 people have deficient PiSS and PiSZ allele combinations, and 60,000 have the PiZZ genotype which is associated with severe deficiency, while more than 24 million people are carriers (PiMS, PiMZ).8

Diagnosis

Variability in clinical presentations results in delayed and misdiagnosis, which means the majority of cases remain undiagnosed (>90%).1,14,15,16 A confirmed AATD diagnosis should involve both quantitative and qualitative laboratory determinations:10,17,18,19

  • Quantitative determination of serum A1PI levels
  • Confirmatory qualitative assessment of genotyping/phenotyping
  • DNA sequencing may be necessary to identify rarer mutations

Navigating AATD

The primary manifestations of AATD are lung disease and liver involvement, which are irreversible and progressive.20 Therefore, the consequences of delayed or misdiagnosis can be fatal in those patients with severe AATD; most commonly due to respiratory failure (58% of deaths), including pneumonia and pneumothorax; and liver diseases (12% of deaths), including liver failure and primary carcinoma.21 This leads to a high disease burden, associated with increased mortality, morbidity, quality of life impairment and cost.21,22,23,24,25,26 Nonpharmacological approaches are crucial to managing AATD and include smoking cessation, maintaining a healthy diet and moderate exercise, staying up to date with recommended immunization and pulmonary rehabilitation.17 Currently, augmentation therapy is the only A1PI pharmacological option available and can be part of the strategy in the management of patients with severe AATD-related emphysema.10,27,28 It is administered by intravenous infusion and aims to increase serum A1PI levels.2 However, the manufacturing process is complex and expensive to produce as it needs to be purified from large volumes of human plasma.29

Medications

This resource provides information on Takeda medications available in the Alpha-1 Antitrypsin Deficiency category and is not intended to represent a complete list of therapeutic options.

Aralast® NP

[Alpha1-Proteinase Inhibitor (Human)]

Glassia®

[Alpha1-Proteinase Inhibitor (Human)]

Videos

Watch videos focused on Alpha-1 Antitrypsin Deficiency (AATD).

AATD Mechanism of Disease

Learn about Alpha-1 Antitrypsin Deficiency (AATD) mechanism of disease in this animated video.

  

   

Scientific Congresses and Resources

This is not intended to be a comprehensive resource of all congresses and congress materials across therapeutic and disease areas. Congress materials may include information about investigational use(s) of compounds/products that are not approved for use by the U.S. Food and Drug Administration (FDA) and/or are inconsistent with the Prescribing Information. Takeda does not recommend the use of any Takeda product beyond the approved labeling. Any decisions regarding the usage of a Takeda product beyond the approved labeling are left to the discretion of the healthcare professional. Takeda makes no representations about whether investigational compounds or unapproved uses will be approved by the FDA.

Immunoglobulin National Society (IgNS), 2025

October 16 - 19, 2025 | Link to Event

National conference of IgNS bringing together professionals and practitioners from all disciplines and clinical specialties to advance Ig therapy practice, while providing networking and comprehensive education opportunities.

American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), 2025

October 29 - November 1, 2025 | Link to Event

Annual meeting dedicated to the advancement of neuromuscular, musculoskeletal, and electrodiagnostic medicine.

American College of Allergy, Asthma & Immunology (ACAAI), 2025

November 6 - 10, 2025 | Link to Event

Global meeting featuring thought leaders from around the world focused on advancing patient care in allergy and immunology.

Annual Meeting American Academy of Allergy Asthma and Immunology (AAAAI), 2026

February 27 - March 2, 2026 | Link to Event

Premier global educational event for allergists and immunologists, with thousands of attendees each year, discussing allergies, asthma, and immune deficiency disorders.

American Academy of Neurology (AAN), 2026

April 18 - 22, 2026 | Link to Event

Each year, the American Academy of Neurology's Annual Meeting offers a robust lineup of diverse learning opportunities covering nearly every topic and subspecialty, helping you stay up to date on the latest trusted science and essential education.

National Home Infusion Association (NHIA), 2026

April 18 - 22, 2026 | Link to Event

Brings together home and alternate site infusion professionals for four days of networking, education, and exhibits. The expo features companies displaying the latest products and services supporting the industry.

Hereditary Angioedema National Summit (HAEA), 2025

July 10 - 13, 2025

This event brings together over 1200 HAE community members, including families, caregivers, healthcare professionals, and pharmaceutical representatives.

Takhzyro® (lanadelumab-flyo)

  • Longitudinal Trend in Attack Outcomes in Patients With Hereditary Angioedema Receiving Long-term Prophylaxis with Lanadelumab: An Observational Study
  • Physician-Reported Attack Rates and Attack Characteristics Among Patients With Hereditary Angioedema Who Extended Dosing With Lanadelumab: An EMPOWER Study Analysis
  • Treatment Outcomes With Lanadelumab by Baseline Hereditary Angioedema Activity: EMPOWER/ENABLE Analysis

Eastern Allergy Conference (EAC), 2025

May 29 - June 1, 2025

Regional annual conference discussing the most current information from top experts in allergy, asthma, and immunology.

Takhzyro® (lanadelumab-flyo)

  • Lanadelumab’s Sustained Effectiveness and Safety for Hereditary Angioedema Long-Term Prophylaxis in Patients From Puerto Rico: Final Results From the EMPOWER Study
  • Understanding the Impact of Long-Term Prophylaxis Switches for Patients With Hereditary Angioedema.

American Thoracic Society (ATS), 2025

May 16 - 21, 2025

International conference showcasing the latest advances in pulmonary disease, critical illness, and sleep disorders for scientists and clinicians at all stages of their careers.

Glassia® [Alpha1- Proteinase Inhibitor (Human)]

  • Application of an Artificial Intelligence Model to Detect Alpha-1 Antitrypsin Deficiency: Characterizing the Study Population
  • Application of an Artificial Intelligence Model to Detect Alpha-1 Antitrypsin Deficiency: Model Performance

Clinical Immunology Society (CIS), 2025

May 1 - 4, 2025

Annual meeting with the goal of providing a stimulating forum with presentations and discussions on the latest advances in clinical immunology, including primary immunodeficiencies and immune dysregulatory diseases.

American Academy of Neurology (AAN), 2025

April 5 - 9, 2025

Annual meeting in neurology promoting high quality patient-centric care in a variety of topics and specialties through various learning formats.

  • Real-World Characteristics and Disease Management for a Virtual Longitudinal Cohort of Patients with Chronic Inflammatory Demyelinating Polyneuropathy

Academy of Managed Care Pharmacy (AMCP), 2025

March 31 - April 3, 2025

Large assembly of pharmacy and healthcare professionals dedicated to the issues of managed care pharmacy, offering immersive education sessions and keynote presentations.

  • Epidemiology, Patient Characteristics, Real-World Treatment Patterns, and Outcomes for Patient with Multifocal Motor Neuropathy (MMN)
  • Disease Severity and Healthcare Resource Utilization for Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Results from an Integrated Database

National Home Infusion Association (NHIA), 2025

March 29 - April 2, 2025

Annual conference ideal for infusion professionals or those seeking opportunities in the industry to come together and explore the latest trends in offering home-based services. 

Annual Meeting American Academy of Allergy Asthma and Immunology (AAAAI), 2025

February 28 - March 3, 2025

Premier global educational event for allergists and immunologists, with thousands of attendees each year, discussing allergies, asthma, and immune deficiency disorders.

Takhzyro® (lanadelumab-flyo)

  • Real-world Episodes of Long-term Prophylaxis for Hereditary Angioedema: A Descriptive Study Using Data From the Consortium of Independent Immunology Clinics
  • Longitudinal Study of Adult Patients With Hereditary Angioedema Receiving Long-term Prophylaxis for 3 Years or Longer With Lanadelumab: Baseline Findings
  • Understanding the Impact of Long-term Prophylaxis Switches for Patients With Hereditary Angioedema

Western Society of Allergy, Asthma and Immunology (WSAAI), 2025

February 9 - 13, 2025

Annual scientific session uniting allergists, immunologists, nurses, and physician assistants aimed at maintaining the highest standard of practice in allergy care.

Takhzyro® (lanadelumab-flyo)

  • Longitudinal Trend in Attack Outcomes in Patients With Hereditary Angioedema Receiving Long-term Prophylaxis With Lanadelumab: An Observational Study
  • Understanding the Impact of Long-term Prophylaxis Treatment Switches on Hereditary Angioedema Attack Characteristics

Cuvitru®[Immune Globulin Subcutaneous (Human)] 20% Solution

  • Clinical characteristics, treatment patterns, and healthcare resource utilization (HCRU) of patients with primary immunodeficiency diseases receiving immunoglobulin subcutaneous (human), 20% solution (Cuvitru) in a large US payer database

International Congress on Neuromuscular Diseases (ICNMD), 2024

October 25 - 29, 2024

This international congress offers attendees an updated view on neuromuscular disorders and networking opportunities to increase their international experience and collaborations.

American College of Allergy, Asthma & Immunology (ACAAI), 2024

October 24 - 28, 2024

Global meeting featuring thought leaders from around the world focused on advancing patient care in allergy and immunology.

Takhzyro® (lanadelumab-flyo)

  • Longitudinal Survey of Adult Patients with Hereditary Angioedema Receiving Long-Term Prophylaxis with Lanadelumab
  • Social Determinants of Health in Hereditary Angioedema and their Impact on Patient Outcomes

Immunoglobulin National Society (IgNS), 2024

October 17 - 20, 2024

National conference of IgNS bringing together professionals and practitioners from all disciplines and clinical specialties to advance Ig therapy practice, while providing networking and comprehensive education opportunities.

  • Real-World Characteristics and Disease Management for a Virtual Longitudinal Cohort of Patients with Chronic Inflammatory Demyelinating Polyneuropathy

The European Society for Immunodeficiencies (ESID), 2024

October 16 - 19, 2024

Biennial meeting that covers the latest discoveries in basic and clinical science covering our expanding field, bringing together internationally renowned scientists and clinicians to present and discuss major developments in diagnosis, clinical management, genetics, and immunobiology of inborn errors of immunity.

  • Cost-Effectiveness Of Next-Generation Sequencing Testing In Patients Eligible For Primary Immunodeficiency Screening In The United States

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