An evidence-based review of the potential role of icatibant in the treatment of acute attacks in hereditary angioedema type I and II

Floccard, Bernard; Hautin, Etienne; Bouillet, Laurence; Coppéré, B.; Allaouchiche, Bernard

doi:10.2147/ce.s24743

Cited by 8 publications

(8 citation statements)

References 50 publications

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“…The theoretical model compares the costs of health professional-only administration (strategy 1) vs. the costs of self-administration option (strategy 2). Since the model assumes that both strategies are equally effective [8,10,11], this is a cost-minimization study. Analyses were performed from two different perspectives: The payer (Spanish National Health System) perspective which considers direct costs only; and the social perspective which considers both direct and indirect costs.…”

Section: Methodsmentioning

confidence: 99%

Social costs of icatibant self-administration vs. health professional-administration in the treatment of hereditary angioedema in Spain

Blasco¹,

Lázaro²,

Caballero

et al. 2013

Health Econ Rev

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BackgroundIcatibant is the only subcutaneous treatment for acute Type I and Type II hereditary angioedema with C1-esterase inhibitor deficiency (HAE-C1-INH) licensed for self-administration in Europe.AimTo compare the economic impact of two icatibant administration strategies: health professional-administration only (strategy 1) versus including the patient self-administration option (strategy 2).MethodsEconomic evaluation model based on the building of a decision tree. Both strategies are assumed to have equivalent effectiveness. The payer (Spanish National Health System) and the social perspectives were considered. All relevant cost-generating factors were taken into account. The time horizon was one year. Sources of information included scientific evidence, official data and experts’ opinion. A deterministic sensitivity analysis was carried out to quantify the underlying uncertainty in the model.ResultsFrom the social perspective, which considers both direct (health care costs) and indirect costs (productivity losses), strategy 2 would result into average savings of €121.30 per acute attack compared to strategy 1. For Spain, this would achieve in an annual savings of €551,371. The reduction in direct costs accounts for 74% of the savings and lower indirect costs account for the remaining 26%. Savings per acute attack may range from €79.50 to €169.80; accordingly, the annual savings in Spain may vary between €90,319 and €2,315,360.ConclusionCosts related to the management of acute HAE attacks with C1 inhibitor deficiency may be substantially reduced through interventions targeting home treatment by training patients to self-administer icatibant.

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Section: Methodsmentioning

confidence: 99%

Social costs of icatibant self-administration vs. health professional-administration in the treatment of hereditary angioedema in Spain

Blasco¹,

Lázaro²,

Caballero

et al. 2013

Health Econ Rev

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“…The route of administration, however, is only by intravenous infusion after proper training by a health care professional which can delay the initiation of treatment and requires practice and drive on the patient’s part. Ecallantide, on the other hand, is only approved for administration in a supervised setting due to the risk of hypersensitivity reactions 52. Moreover, icatibant is less expensive than ecallantide and has an equivalent cost profile to that of the C1-INH Berinert® 53.…”

Section: Conclusion and Place In Therapymentioning

confidence: 99%

Hereditary angioedema: epidemiology, management, and role of icatibant

Ghazi¹

2013

BTT

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Hereditary angioedema (HAE) is an autosomal dominant, potentially life-threatening condition, manifesting as recurrent and self-limiting episodes of facial, laryngeal, genital, or peripheral swelling with abdominal pain secondary to intra-abdominal edema. The estimated prevalence of HAE in the general population is one individual per 50,000, with reported ranges from 1:10,000 to 1:150,000, without major sex or ethnic differences. Various treatment options for acute attacks and prophylaxis of HAE are authorized and available in the market, including plasma-derived (Berinert®, Cinryze®, and Cetor®) and recombinant (Rhucin® and Ruconest™) C1 inhibitors, kallikrein inhibitor-ecallantide (Kalbitor®), and bradykinin B2 receptor antagonist-icatibant (Firazyr®). Some of these drugs are used only to treat HAE attacks, whereas others are only approved for prophylactic therapies and all of them have improved disease outcomes due to their different mechanisms of action. Bradykinin and its binding to B2 receptor have been demonstrated to be responsible for most of the symptoms of HAE. Thus icatibant (Firazyr®), a bradykinin B2 receptor antagonist, has proven to be an effective and more targeted treatment option and has been approved for the treatment of acute attacks of HAE. Rapid and stable relief from symptoms of cutaneous, abdominal, or laryngeal HAE attacks has been demonstrated by 30 mg of icatibant in Phase III clinical trials. Self-resolving mild to moderate local site reactions after subcutaneous injection of icatibant were observed. Icatibant is a new, safe, and effective treatment for acute attacks of HAE. HAE has been reported to result in enormous humanistic burden to patients, affecting both physical and mental health, with a negative impact on education, career, and work productivity, and with substantial economic burdens. The timely and proper use of disease-specific treatments could improve patients’ quality of life, reduce the disease-specific morbidity and mortality, and, last but not least, reduce costs associated with hospitalizations and emergency room visits. Therefore, the paradigm of HAE treatment has the potential to evolve significantly, thereby exponentially improving a patient’s quality of life.

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“…The kinins exert pharmacological effects through the kinin B 1 and B 2 receptors [22,25]. Gram-negative bacteria produce endotoxin (Lipopolysaccharide, LPS) that induces acute lung injury via activation of kinin B 1 receptors [26], and blockage of kinin B 1 receptor by its antagonist R954 inhibits eosinophil activation and proliferation in murine asthma [27].…”

Section: Introductionmentioning

confidence: 99%

MAPK/NF-κB-dependent upregulation of kinin receptors mediates airway hyperreactivity: A new perspective for the treatment

Zhang

Cardell

Edvinsson

et al. 2013

Pharmacological Research

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An evidence-based review of the potential role of icatibant in the treatment of acute attacks in hereditary angioedema type I and II

Cited by 8 publications

References 50 publications

Social costs of icatibant self-administration vs. health professional-administration in the treatment of hereditary angioedema in Spain

Social costs of icatibant self-administration vs. health professional-administration in the treatment of hereditary angioedema in Spain

Hereditary angioedema: epidemiology, management, and role of icatibant

MAPK/NF-κB-dependent upregulation of kinin receptors mediates airway hyperreactivity: A new perspective for the treatment

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