title: [Administration of conestat alfa, human C1 esterase inhibitor and icatibant in the treatment of acute angioedema attacks in adults with hereditary angioedema due to C1 esterase inhibitor deficiency. Treatment comparison based on systematic review results].
abstract: BACKGROUND
  Hereditary angioedema (HAE) is a genetic disease caused by C1-esterase inhibitor deficiency, characterized by recurrent attacks of intense, massive, localized subcutaneous oedema that can involve all parts of the body. The aim of this study is a comparison of the clinical effectiveness of conestat alfa, human C1 esterase inhibitor (C1INH), and icatibant in the treatment of acute angioedema attacks in adults with HAE.
  
  
  METHODS
  A systematic review of literature published up to May 2012 was performed to assess the efficacy and safety of conestat alfa, C1INH, and icatibant in the treatment of acute angioedema attacks in adults with HAE. Databases were searched at MEDLINE (PubMed), EMBASE, and Cochrane. The general search structure was designed as a combination of keywords or synonyms: (hereditary angioedema) AND (conestat alfa OR human C1 esterase inhibitor concentrate OR synonyms OR icatibant). Only randomized clinical studies were selected.
  
  
  RESULTS
  Systematic review yielded no clinical trials directly comparing the therapeutic options mentioned. Two randomized clinical trials were found which compared each of the following: conestat alfa, C1INH, and icatibant with placebo. Based on the gathered evidence it was demonstrated that taking any of the medicinal substances mentioned in the treatment of acute angioedema attack results in shorter time to beginning of relief of symptoms, time to minimal symptoms, the probability of the treatment response after 4 hours is increased, and the safety profile is comparable to placebo.
  
  
  CONCLUSIONS
  Due to significant heterogeneity of identified trials, the scientific evidence available was insufficient to point out the most effective therapeutic option in the treatment of acute oedemas in HAE.
authors: Zakład Gospodarki Lekiem, Instytut Zdrowia Publicznego, Wydział Nauk o Zdrowiu UJ, ul. Grzegórzecka 20, Kraków. pawel..kawalec@uj.edu.pl
authors: Paweł
authors: P
authors: Kawalec
authors: Przemysław
authors: P
authors: Holko
authors: Anna
authors: A
authors: Paszulewicz
authors: Krystyna
authors: K
authors: Obtułowicz
mesh_terms: D000328:Adult; D000368:Aged; D054179:Angioedemas, Hereditary / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001920:Bradykinin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D050718:Complement C1 Inhibitor Protein / Q000627:therapeutic use*; D051056:Complement Inactivating Agents / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D050718:Complement C1 Inhibitor Protein; D051056:Complement Inactivating Agents; D011994:Recombinant Proteins; C571093:conestat alfa; C065679:icatibant; D001920:Bradykinin