The only option is to re-insert the block with vla-insertblock after adding with vla-AddAttribute the IAcadAttribute to the IAcadBlock...
Not entirely true if you step outside the confines of activex. If you walk a block instance's linked list ... gathering the dxf data as you go for the insert, attributes ... add any new desired ATTRIB's dxf data, cap it with a proper SEQEND def, then entmake each entry (after stripping any -1, -2, 5 or 330 entries). Subtitle: you don't have to add the ATTDEFs to the block definition. Yes/Note: the new block instance will not match the block definition. I was using this technique about 20 years ago and it still works -- I had ATTRIB-less block defs -- adding constant attributes on the fly -- per instance -- as need dictated.