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

Bernard Floccard,1 Etienne Hautin,1 Laurence Bouillet,2 Brigitte Coppere,3 Bernard Allaouchiche11Département d'Anesthésie Réanimation, Centre de Référence des Angi dèmes à Bradykinine, Hospices Civils de Lyon, H pital Edouard Herriot, Lyon, 2Clinique Universitaire de Médecine Interne, Centre National de Référence des Angi dèmes à Bradykinine, CHU de Grenoble, Grenoble, 3Service de Médecine Interne, Centre de Référence des Angi dèmes à Bradykinine, Hospices Civils de Lyon, H pital Edouard Herriot, Lyon, FranceIntroduction: Icatibant, a first-in-class B2 bradykinin receptor antagonist, appears to have a favorable efficacy and safety profile for the treatment of acute attacks of hereditary angioedema in adults.Aims: To update the evidence and provide an overview of the available data on icatibant.Evidence review: Peer reviewed articles published and listed in Medline Search and published updated guidelines for the treatment of acute attacks in hereditary angioedema type I and II in adults were reviewed. The validity and quality of evidence were evaluated.Place in therapy: Clinical evidence for the treatment of acute hereditary angioedema attacks with icatibant is strong. Approximately 10% of the patients require a second dose. No serious adverse reactions have been reported. The only significant side effects consistently registered by 90% of patients are transient local pain, swelling, and erythema at the local injection site.Conclusion: Subcutaneously administered 30 mg icatibant has been shown to be a safe and efficacious treatment in clinical trials. It is the only specific treatment authorized for self-administration by the subcutaneous route offering increased patient independence.Keywords: icatibant, hereditary angioedema, self-administration, acute attacks