Successful treatment of ACE inhibitor‐induced angioedema with icatibant, a bradykinin B2 receptor antagonist

Off-Label Use of Agents for Management of Serious or Life-threatening Angiotensin Converting Enzyme Inhibitor–Induced Angioedema

“…Intubation and tracheotomy were avoided in several cases following icatibant administration. 35,[40][41][42]46,48 Icatibant was not successful in one case; however, the reason for lack of benefit in this case is unknown. 38 Two case series comparing icatibant-treated patients with those previously treated with standard therapies found statistically significant improvements in time to complete symptom resolution.…”

“…8,9,15,35,43 Several case reports and case series illustrate the efficacy of icatibant in the management of these events. 34-45 In the majority of these patients, icatibant was used as a second- or third-line therapy with successful symptom resolution ranging from 10 to 30 minutes or 4 to 10 hours. Intubation and tracheotomy were avoided in several cases following icatibant administration.…”

“…16,33 Case reports/series involving the management of ACEI-IA with icatibant are summarized in Table 3. [34][35][36][37][38][39][40][41][42][43][44][45] Icatibant successfully resolved symptoms in 25 of the 26 cases (96%). Treatment with standard therapy and icatibant did not improve symptoms in one case leading to intubation and ICU management with eventual resolution and discharge a few days after presentation.…”

“…Summary of Select Published Case Reports/Series of Icatibant for ACEI-Induced Angioedema Treatment [34][35][36][37][38][39][40][41][42][43][44][45]. …”

Icatibant is not an appropriate treatment option for ACE-inhibitor induced angioedema of the head and neck

“…Initial PubMed search identified eleven case reports that described the use of icatibant as a treatment for ACE-inhibitor induced angioedema of the head and neck, with mixed results among cases. [3][4][5][6][7][8][9][10][11][12][13] Three of the results from the literature search included clinical trials, which offered more robust study designs and results than the aforementioned case reports. Baş et al first reported in 2015 that icatibant does offer potential benefits when used as a treatment for ACE-inhibitor induced angioedema of the head and neck.…”