Icatibant Evaluated for ACE Inhibitor-Induced Angioedema

Upper airway angioedema, while rare, is a potentially life-threatening side effect of ACEIs.
Upper airway angioedema, while rare, is a potentially life-threatening side effect of ACEIs.

Icatibant, a bradykinin B2 receptor antagonist, was no better than placebo in treating moderately severe angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema of the upper airway, according to a study published in The Journal of Allergy and Clinical Immunology: In Practice.

Upper airway angioedema, while rare, is a potentially life-threatening side effect of ACEIs. As there is currently no therapy approved to treat it, a team of researchers, led by Richard Sinert, DO, from SUNY Downstate Medical Center/Kings County Hospital Medical Center, Brooklyn, NY, evaluated whether icatibant was effective in patients with ACEI-induced angioedema. 

In the multicenter study (n=121), adult patients taking ACEIs who presented within 12 hours of the onset of at least moderately severe angioedema were randomized 1:1 to subcutaneous icatibant 30mg or placebo. The primary efficacy endpoint was time to meeting discharge criteria after receiving the study drug based on the severity of airway symptoms. Of the total patients, 118 received treatment (median 7.8 hours from symptom onset).

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Researchers found no difference in time to meeting discharge criteria between the groups (median 4.0 hours each; P=0.63). There was also no difference in time to onset of symptom relief seen between the icatibant group vs. placebo (2.0 hours vs. 1.6 hours; P=0.57). The findings were similar regardless of symptom severity, time interval to treatment, age, and other clinical factors. 

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