title: Hereditary angioedema attacks resolve faster and are shorter after early icatibant treatment.
abstract: BACKGROUND
  Attacks of hereditary angioedema (HAE) are unpredictable and, if affecting the upper airway, can be lethal. Icatibant is used for physician- or patient self-administered symptomatic treatment of HAE attacks in adults. Its mode of action includes disruption of the bradykinin pathway via blockade of the bradykinin B(2) receptor. Early treatment is believed to shorten attack duration and prevent severe outcomes; however, evidence to support these benefits is lacking.
  
  
  OBJECTIVE
  To examine the impact of timing of icatibant administration on the duration and resolution of HAE type I and II attacks.
  
  
  METHODS
  The Icatibant Outcome Survey is an international, prospective, observational study for patients treated with icatibant. Data on timings and outcomes of icatibant treatment for HAE attacks were collected between July 2009-February 2012. A mixed-model of repeated measures was performed for 426 attacks in 136 HAE type I and II patients.
  
  
  RESULTS
  Attack duration was significantly shorter in patients treated <1 hour of attack onset compared with those treated ≥ 1 hour (6.1 hours versus 16.8 hours [p<0.001]). Similar significant effects were observed for <2 hours versus ≥ 2 hours (7.2 hours versus 20.2 hours [p<0.001]) and <5 hours versus ≥ 5 hours (8.0 hours versus 23.5 hours [p<0.001]). Treatment within 1 hour of attack onset also significantly reduced time to attack resolution (5.8 hours versus 8.8 hours [p<0.05]). Self-administrators were more likely to treat early and experience shorter attacks than those treated by a healthcare professional.
  
  
  CONCLUSIONS
  Early blockade of the bradykinin B(2) receptor with icatibant, particularly within the first hour of attack onset, significantly reduced attack duration and time to attack resolution.
authors: Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany. Marcus.Maurer@charite.de
authors: Marcus
authors: M
authors: Maurer
authors: Werner
authors: W
authors: Aberer
authors: Laurence
authors: L
authors: Bouillet
authors: Teresa
authors: T
authors: Caballero
authors: Vincent
authors: V
authors: Fabien
authors: Gisèle
authors: G
authors: Kanny
authors: Allen
authors: A
authors: Kaplan
authors: Hilary
authors: H
authors: Longhurst
authors: Andrea
authors: A
authors: Zanichelli
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D001920:Bradykinin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D065094:Bradykinin B2 Receptor Antagonists; D004334:Drug Administration Schedule; D005260:Female; D056829:Hereditary Angioedema Types I and II / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012646:Self Administration; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D065094:Bradykinin B2 Receptor Antagonists; C065679:icatibant; D001920:Bradykinin
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