title: Icatibant, an inhibitor of bradykinin receptor 2, for hereditary angioedema attacks: prospective experimental single-cohort study.
abstract: OBJECTIVE
  Hereditary angioedema (HAE) with C1 inhibitor deficiency manifests as recurrent episodes of edema involving the skin, upper respiratory tract and gastrointestinal tract. It can be lethal due to asphyxia. The aim here was to evaluate the response to therapy for these attacks using icatibant, an inhibitor of the bradykinin receptor, which was recently introduced into Brazil.
  
  
  METHODS
  Prospective experimental single-cohort study on the efficacy and safety of icatibant for HAE patients.
  
  
  METHODS
  Patients with a confirmed HAE diagnosis were enrolled according to symptoms and regardless of the time since onset of the attack. Icatibant was administered in accordance with the protocol that has been approved in Brazil. Symptom severity was assessed continuously and adverse events were monitored.
  
  
  RESULTS
  24 attacks in 20 HAE patients were treated (female/male 19:1; 19-55 years; median 29 years of age). The symptoms were: subcutaneous edema (22/24); abdominal pain (15/24) and upper airway obstruction (10/24). The time taken until onset of relief was: 5-10 minutes (5/24; 20.8%); 10-20 (5/24; 20.8%); 20-30 (8/24; 33.4%); 30-60 (5/24; 20.8%); and 2 hours (1/24; 4.3%). The time taken for complete resolution of symptoms ranged from 4.3 to 33.4 hours. Adverse effects were only reported at injection sites. Mild to moderate erythema and/or feelings of burning were reported by 15/24 patients, itching by 3 and no adverse effects in 6.
  
  
  CONCLUSIONS
  HAE type I patients who received icatibant responded promptly; most achieved improved symptom severity within 30 minutes. Local adverse events occurred in 75% of the patients.
authors: Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors: Regis Albuquerque
authors: RA
authors: Campos
authors: Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Solange Oliveira Rodrigues
authors: SO
authors: Valle
authors: Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Alfeu Tavares
authors: AT
authors: França
authors: Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil.
authors: Elisabete
authors: E
authors: Cordeiro
authors: Department of Internal Medicine, Escola Superior de Ciências, Santa Casa de Misericórdia de Vitória, Vitória, Espírito Santo, Brazil.
authors: Faradiba Sarquis
authors: FS
authors: Serpa
authors: Hospital Edmundo Vasconcelos, São Paulo, São Paulo, Brazil.
authors: Yara Ferreira
authors: YF
authors: Mello
authors: Hospital Edmundo Vasconcelos, São Paulo, São Paulo, Brazil.
authors: Teresinha
authors: T
authors: Malheiros
authors: Department of Pediatrics, Faculdade de Medicina, Universidade de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
authors: Eliana
authors: E
authors: Toledo
authors: Department of Pediatrics, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors: Elie
authors: E
authors: Mansour
authors: Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Gustavo
authors: G
authors: Fusaro
authors: Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil.
authors: Anete Sevciovic
authors: AS
authors: Grumach
mesh_terms: D000328:Adult; D017677:Age Distribution; D054179:Angioedemas, Hereditary / Q000150:complications / Q000188:drug therapy*; D001920:Bradykinin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D065094:Bradykinin B2 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil; D015331:Cohort Studies; D004487:Edema / Q000188:drug therapy; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D040521:Subcutaneous Tissue / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D065094:Bradykinin B2 Receptor Antagonists; C065679:icatibant; D001920:Bradykinin