• Regis Albuquerque Campos, Solange Oliveira Rodrigues Valle, Alfeu Tavares França, Elisabete Cordeiro, Faradiba Sarquis Serpa, Yara Ferreira Mello, Teresinha Malheiros, Eliana Toledo, Elie Mansour, Gustavo Fusaro, and Anete Sevciovic Grumach.
• Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
• Sao Paulo Med J. 2014 Jan 1; 132 (5): 261265261-5.

Context And ObjectiveHereditary angioedema (HAE) with C1 inhibitor deficiency manifests as recurrent episodes of edema involving the skin, upper respiratory tract and gastrointestinal tract. It can be lethal due to asphyxia. The aim here was to evaluate the response to therapy for these attacks using icatibant, an inhibitor of the bradykinin receptor, which was recently introduced into Brazil.Design And SettingProspective experimental single-cohort study on the efficacy and safety of icatibant for HAE patients.MethodsPatients with a confirmed HAE diagnosis were enrolled according to symptoms and regardless of the time since onset of the attack. Icatibant was administered in accordance with the protocol that has been approved in Brazil. Symptom severity was assessed continuously and adverse events were monitored.Results24 attacks in 20 HAE patients were treated (female/male 19:1; 19-55 years; median 29 years of age). The symptoms were: subcutaneous edema (22/24); abdominal pain (15/24) and upper airway obstruction (10/24). The time taken until onset of relief was: 5-10 minutes (5/24; 20.8%); 10-20 (5/24; 20.8%); 20-30 (8/24; 33.4%); 30-60 (5/24; 20.8%); and 2 hours (1/24; 4.3%). The time taken for complete resolution of symptoms ranged from 4.3 to 33.4 hours. Adverse effects were only reported at injection sites. Mild to moderate erythema and/or feelings of burning were reported by 15/24 patients, itching by 3 and no adverse effects in 6.ConclusionHAE type I patients who received icatibant responded promptly; most achieved improved symptom severity within 30 minutes. Local adverse events occurred in 75% of the patients.

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