“Emerging role of plasma kallikrein inhibitors in preventing hereditary angioedema flares in pregnancy”

Hereditary angioedema (HAE) presents a significant therapeutic challenge during pregnancy, a period often associated with increased attack frequency and severity. The management of HAE in pregnancy is complicated by physiological changes and limited fetal safety data for many prophylactic agents. Recent advancements in long-acting prophylaxis, particularly monoclonal antibodies targeting plasma kallikrein such as Navenibart (STAR-0215), offer a promising new therapeutic approach. With an extended half-life of up to 105 days, Navenibart enables infrequent dosing (every 3-6 months), potentially reducing treatment burden and improving coverage through critical gestational periods. However, its use in pregnant patients remains strictly investigational, as no clinical safety or efficacy data exist for this population. This article examines the emerging role of plasma kallikrein inhibitors in HAE prophylaxis during pregnancy, discusses the pharmacologic profile and potential advantages of Navenibart, and proposes cautious, preliminary clinical considerations within a shared decision-making framework. Multidisciplinary care and further research are urgently needed to establish safety and define the place of these agents in obstetric HAE management.