Icatibant, a Selective Bradykinin B2 Receptor Antagonist Used in Hereditary Angioedema Due to C1 Inhibitor Deficiency

Abstract

RATIONALE: Icatibant is a novel bradykinin B2 receptor antagonist used in hereditary angioedema. To present efficacy and safety data in daily practice outside of clinical trials.METHODS: 10 patients (5 women, 5 men) with hereditary angioedema received 30 mg icatibant subcutaneously for 10 acute attacks (6 abdominal pain attacks, 3 arm swellings, and 1 facial swelling). Times between the beginning of the attack, the injection, the first relief of symptoms and the end of symptoms were determined and compared with 10 earlier attacks in the same location per patient.RESULTS: Time between attack onset and icatibant injection was 3.1±1.2 hours in the mean. The mean time between the injection and the first symptom relief was 30±16.4 minutes for abdominal attacks and 41.3±14.4 minutes for skin swellings. In untreated attacks, the mean time to first symptom relief was 26.2± 9.2 hours in abdominal attacks and 46.6±14.7 hours in skin swellings. The total duration of the treated attacks was 18.8±21.4 hours in abdominal attacks and 16.1±14.2 hours in skin swellings. The duration of untreated attacks was 79± 44.3 hours in abdominal attacks and 81±16.9 hours in skin swellings. One patient had a return of abdominal symptoms 6 hours after the icatibant injection. Side effects included reactions at the injection sites which resolved without medical intervention.CONCLUSIONS: Treatment of acute attacks of hereditary angioedema in daily practice confirms efficacy data of icatibant as shown in clinical trials. RATIONALE: Icatibant is a novel bradykinin B2 receptor antagonist used in hereditary angioedema. To present efficacy and safety data in daily practice outside of clinical trials. METHODS: 10 patients (5 women, 5 men) with hereditary angioedema received 30 mg icatibant subcutaneously for 10 acute attacks (6 abdominal pain attacks, 3 arm swellings, and 1 facial swelling). Times between the beginning of the attack, the injection, the first relief of symptoms and the end of symptoms were determined and compared with 10 earlier attacks in the same location per patient. RESULTS: Time between attack onset and icatibant injection was 3.1±1.2 hours in the mean. The mean time between the injection and the first symptom relief was 30±16.4 minutes for abdominal attacks and 41.3±14.4 minutes for skin swellings. In untreated attacks, the mean time to first symptom relief was 26.2± 9.2 hours in abdominal attacks and 46.6±14.7 hours in skin swellings. The total duration of the treated attacks was 18.8±21.4 hours in abdominal attacks and 16.1±14.2 hours in skin swellings. The duration of untreated attacks was 79± 44.3 hours in abdominal attacks and 81±16.9 hours in skin swellings. One patient had a return of abdominal symptoms 6 hours after the icatibant injection. Side effects included reactions at the injection sites which resolved without medical intervention. CONCLUSIONS: Treatment of acute attacks of hereditary angioedema in daily practice confirms efficacy data of icatibant as shown in clinical trials.