Antihypertensive drug associated angioedema: effect modification by race/ethnicity

Reichman, Marsha E.; Wernecke, Michael; Liao, Jiemin; Yap, John Erikson L.; Chillarige, Yoganand; Southworth, Mary Ross; Keeton, Stephine; Goulding, Margie R.; Mott, Katrina; Kelman, Jeffrey A.

doi:10.1002/pds.4260

Cited by 17 publications

(9 citation statements)

References 26 publications

(41 reference statements)

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“…The incidence was the highest in the first 30 days of treatment. These data confirm earlier findings of Reichman et al [3]. The prevalence of mortality associated with drugs was 136 cases (8%) according to Kim et al [4••].…”

Section: Introductionsupporting

confidence: 92%

Current Treatment of Angioedema Induced by ACE Inhibitors

Terreehorst

Reitsma

Cohn

2019

Curr Treat Options Allergy

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Purpose of Review Angioedema is a well-known side effect of ACE inhibitors. Current knowledge shows that the underlying pathophysiological mechanism is an excess of bradykinin, most likely due to ineffective breakdown pathways. Since C1 inhibitor deficiency has the same pathophysiological background, it would be logical to assume that C1 inhibitor deficiency treatments could be of use in ACE inhibitor-induced angioedema. The objective of this review was to evaluate the evidence for treatment of ACE inhibitorinduced angioedema by means of drugs intervening in the bradykinin system. Recent Findings We searched in the literature for double-blind placebo-controlled trials using either inhibitors of production of kallikrein, bradykinin receptor antagonists, C1 inhibitor concentrate, or fresh frozen plasma as treatment for ACE inhibitor-induced angioedema. The reference list of retrieved articles was checked for articles with the same subject (snowballing). The evidence for each treatment was evaluated by IT and DMC. Summary Double-blind placebo-controlled trials were only found for ecallantide and icatibant. Both treatments did not show superiority over conventional treatment with histamine receptor antagonists and steroids. No double-blind placebo-controlled trials were found of fresh frozen plasma or C1 inhibitor concentrate. To date, there is insufficient evidence for the use of bradykinin receptor antagonists and kallikrein production inhibitors. Although case reports regarding the use of fresh frozen plasma and C1 inhibitor concentrate are positive, well-designed trials are lacking. Drug Allergy (L Mayorga, Section Editor)

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Section: Introductionsupporting

confidence: 92%

Current Treatment of Angioedema Induced by ACE Inhibitors

Terreehorst

Reitsma

Cohn

2019

Curr Treat Options Allergy

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“…41 This increase in angioedema was mirrored by 2 additional studies; however, the individualized increase with specific ACE inhibitors was not duplicated or presented. 42,43 These studies were retrospective analyses of electronic medical records, with one of the studies only documenting adverse drug events that led to discontinuation of the ACE inhibitor. [41][42][43] A more recent prospective study evaluating enalapril showed an approximately 3-fold increase in risk of angioedema with blacks compared with whites.…”

Section: Adverse Effects With Ace Inhibitors In Black Patientsmentioning

confidence: 99%

A Review of ACE Inhibitors and ARBs in Black Patients With Hypertension

2018

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“…With respect to ethnic differences, it has been observed that cough is more common in people of East Asian descent, whereas ACEi-A is more prevalent in people of African descent. 125 It remains unexplained why ACEi-A occurs variably in small subsets of patients and less commonly than cough.…”

Section: Discussionmentioning

confidence: 99%

“…123 has been the accumulation of bradykinin and substance P due to the direct inhibition of ACE. 125 It remains unexplained why ACEi-A occurs variably in small subsets of patients and less commonly than cough. With respect to ethnic differences, it has been observed that cough is more common in people of East Asian descent, whereas ACEi-A is more prevalent in people of African descent.…”

Section: Genes In Fibrinolytic and Coagulation Pathwaysmentioning

confidence: 99%

Pharmacogenetics of angiotensin‐converting enzyme inhibitor‐induced angioedema

Liau

Chua

Kennedy

et al. 2019

Clin Experimental Allergy

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Angioedema is a rare adverse effect of the commonly used angiotensin-converting enzyme inhibitors (ACEi) and is reported to occur with a prevalence of 0.1%-0.7%.Although most ACEi-induced angioedema (ACEi-A) cases are mild, severe cases requiring intensive care and even resulting in death have been reported in the literature. The mechanisms underlying ACEi-A are not yet fully understood, but bradyki-

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Antihypertensive drug associated angioedema: effect modification by race/ethnicity

Abstract: There was significant effect modification of angioedema risk by race and ACEI use for blacks, but not for other race/ethnicity groups. Angioedema risk was significantly greater in the first 30 days of exposure for all, and highest among blacks.

Cited by 17 publications

References 26 publications

Current Treatment of Angioedema Induced by ACE Inhibitors

Current Treatment of Angioedema Induced by ACE Inhibitors

A Review of ACE Inhibitors and ARBs in Black Patients With Hypertension

Pharmacogenetics of angiotensin‐converting enzyme inhibitor‐induced angioedema

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