Novel Therapies for Angiotensin-Converting Enzyme Inhibitor–Induced Angioedema: A Systematic Review of Current Evidence

Riha, Heidi; Summers, Bryant B; Rivera, Jessica V.; Berkel, Megan A. Van

doi:10.1016/j.jemermed.2017.05.037

Cited by 27 publications

(41 citation statements)

References 45 publications

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“…There have been three randomized trials evaluating the use of icatibant in ACE inhibitor angioedema. Interestingly, the first study found icatibant to be effective while the more recent and larger studies found no significant difference in time to recovery (3,6,(9)(10)(11)(12). Icatibant is costly with a wholesale price of $9,000-$11,000 and may not be available at all hospitals.…”

Section: Discussionmentioning

confidence: 99%

ACE inhibitor related angioedema: a case report and brief review

Boudi¹,

Rush²,

Farsar³

et al. 2017

Southwest J Pulm Crit Care

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Section: Discussionmentioning

confidence: 99%

ACE inhibitor related angioedema: a case report and brief review

Boudi¹,

Rush²,

Farsar³

et al. 2017

Southwest J Pulm Crit Care

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“…angioneurotic edema) is characterized by excessive vasodilation and permeability of vessels in the deepest layers of the skin and in subcutaneous and submucosal tissue. Postcapillary venules are the primary target . Angioedema can arise from allergic reactions to different drugs (i.e., histamine‐mediated angioedema with urticaria), but this is beyond the scope of this review.…”

Section: Drug Affecting Primarily the Vascular Systemmentioning

confidence: 99%

“…Importantly, African Americans are four to five times more likely than Caucasians to experience angioedema. Genetic polymorphism in aminopeptidase P, which is a major degrading enzyme for bradykinin during ACE‐inhibition, seems to play a role . Common treatments for histamine‐mediated angioedema (such as antihistamines and glucocorticoids) are not effective in this setting.…”

Section: Drug Affecting Primarily the Vascular Systemmentioning

confidence: 99%

“…Postcapillary venules are the primary target. 485 Angioedema can arise from allergic reactions to different drugs (i.e., histamine-mediated angioedema with urticaria), but this is beyond the scope of this review. More relevant cases are drug-induced angioedema without urticaria, which is usually kinin-mediated.…”

Section: Drugs Causing Angioedemamentioning

confidence: 99%

“…It is typically associated with ACE inhibitor therapy, where it is attributed to excessive effects induced by bradykinin, which is physiologically degraded by the ACE enzyme. 485,486 Angioedema often affects soft tissue of the head such as lips, face, tongue, periorbital tissue and may cause obstruction of oropharyngeal airways that can be dangerous. 487 Swelling is accompanied by characteristic erythema (without itching) and pain/discomfort.…”

Section: Drugs Causing Angioedemamentioning

confidence: 99%

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Comprehensive review of cardiovascular toxicity of drugs and related agents

Mladěnka

Applová

Patočka

et al. 2018

Medicinal Research Reviews

203

120

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Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta‐blockers, calcium channel blockers, female hormones, nonsteroidal anti‐inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.

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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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Novel Therapies for Angiotensin-Converting Enzyme Inhibitor–Induced Angioedema: A Systematic Review of Current Evidence

Cited by 27 publications

References 45 publications

ACE inhibitor related angioedema: a case report and brief review

ACE inhibitor related angioedema: a case report and brief review

Comprehensive review of cardiovascular toxicity of drugs and related agents

Current Treatment of Angioedema Induced by ACE Inhibitors

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