Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant)

Details

Serval ID
serval:BIB_F50EB5C47B7A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant)
Journal
Journal of Allergy and Clinical Immunology
Author(s)
Bork  K., Frank  J., Grundt  B., Schlattmann  P., Nussberger  J., Kreuz  W.
ISSN
0091-6749 (Print)
Publication state
Published
Issued date
06/2007
Volume
119
Number
6
Pages
1497-503
Notes
Clinical Trial, Phase I
Journal Article --- Old month value: Jun
Abstract
BACKGROUND: In hereditary angioedema, bradykinin is assumed to be the most important mediator of edema formation. OBJECTIVE: To assess whether the selective bradykinin receptor-2 antagonist Icatibant is effective in acute edema attacks of hereditary angioedema. METHODS: In this uncontrolled pilot study, 15 patients with 20 attacks were treated with Icatibant. The attacks were analyzed by using a standardized and validated visual analog scale measurement and compared with historical data of untreated attacks. Plasma bradykinin concentration was measured before and 4 hours after intravenous Icatibant treatment. RESULTS: Symptom intensity decreased within 4 hours after administration of Icatibant; the median time to onset of symptom relief was 1.50, 1.42, and 1.13 hours in the intravenous groups and 0.58 and 0.45 hours in the subcutaneous groups, respectively. The median difference in the 10-cm visual analog scale 4 hours after start of treatment was 4.11 cm (95% CI, 1.72-6.07). Compared with untreated attacks, Icatibant treatment reduced the mean (SD) time to onset of symptom relief by 97% from 42 +/- 14 to 1.16 +/- 0.95 hours (all groups combined). Median bradykinin concentration was 7-fold above the norm during acute attacks at 48.5 pmol/L and decreased to 18.0 pmol/L 4 hours after Icatibant infusion or injection. CONCLUSION: Icatibant was effective in treating acute attacks of hereditary angioedema. CLINICAL IMPLICATIONS: This is the first report demonstrating the clinical usefulness of antagonizing bradykinin binding to bradykinin receptor-2 in hereditary angioedema.
Keywords
Acute Disease Adult Angioneurotic Edema/*drug therapy/genetics/*metabolism Bradykinin/adverse effects/*analogs & derivatives/therapeutic use Female Genetic Diseases, Inborn/drug therapy/metabolism Humans Male Middle Aged Pilot Projects Receptor, Bradykinin B2/*antagonists & inhibitors
Pubmed
Web of science
Create date
05/03/2008 16:41
Last modification date
20/08/2019 16:21
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