Icatibant for the Treatment of Hereditary Angioedema

2012 ◽  
Vol 47 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Sabrina W Cole ◽  
Lisa M Lundquist
Keyword(s):  
Clinical Trials ◽  
Tranexamic Acid ◽  
Receptor Antagonist ◽  
Effective Treatment ◽  
Median Time ◽  
Hereditary Angioedema ◽  
Treatment Options ◽  
Rare Condition ◽  
Acute Attacks ◽  
Clinically Significant

OBJECTIVE To review the pharmacology, pharmacokinetics, clinical trials, and safety of icatibant, a recently approved bradykinin B2 receptor antagonist for treatment of acute attacks of hereditary angioedema (HAE). DATA SOURCES Articles indexed in MEDLINE (1948-June 2012), International Pharmaceutical Abstracts(1970-May 2012), and Cumulative Index to Nursing and Allied Health Literature (1981-June 2012) were identified using the search terms icatibant, bradykinin B2 receptor antagonist, and hereditary angioedema. Additional references were identified from the reference lists of the articles identified. STUDY SELECTION AND DATA EXTRACTION English-language articles were reviewed. DATA SYNTHESIS Icatibant was evaluated in 3 Phase 3 clinical trials and found to be a safe and effective option for treatment of acute HAE. Icatibant was compared to placebo in 2 clinical trials (FAST-1 and FAST-3) and to tranexamic acid in the FAST-2 trial. Patients receiving icatibant in FAST-1 did not experience a significant improvement in median time to clinically significant relief of the index symptom (p = 0.14), whereas patients receiving icatibant in FAST-3 experienced a significant improvement in median time to at least 50% reduction in symptom severity (p < 0.001). When icatibant was compared to tranexamic acid in FAST-2, the median time to clinically significant relief of the index symptom was shorter for patients receiving icatibant (p < 0.001). The most common adverse events associated with the administration of icatibant were injection-site reactions, which were mild to moderate and transient. These data suggest that icatibant is a safe and effective treatment for acute attacks of HAE. Although direct comparisons of recently approved alternatives for treatment of acute attacks are lacking, there are administration advantages of icatibant over other agents. Additionally, the cost of icatibant is comparable to that of the C1 esterase inhibitor Berinert and less expensive than ecallantide. CONCLUSIONS Available efficacy data support that icatibant should be considered a safe and effective treatment for acute attacks of HAE. Additionally, limited treatment options for this rare condition, ease of administration, and comparable cost profile support its consideration for formulary inclusion.

scholarly journals Possible treatments of COVID-19 present and future

2020 ◽  
Vol 9 (8) ◽  
pp. 1292
Author(s):  
Saif Ul Islam
Keyword(s):  
Clinical Trials ◽  
Effective Treatment ◽  
Treatment Options ◽  
Limited Time ◽  
Infectivity Rate ◽  
Genetic Shift ◽  
High Infectivity

Since the outbreak of COVID-19 infection in December 2019, millions of people are infected, and thousands of people have died. Genetic shift and high infectivity rate made SARS-Cov-2 a pandemic. Doctors, researchers, and world leaders are scratching their heads, how to contained or treat the virus. Several treatment options are tried, but so far, there is no effective treatment available. Thousands of articles are published about COVID-19, and so much information is available that it is challenging for a practicing physician to review these articles in the limited time they have. This article summarized the treatment options for COVID-19 that have tried or are in clinical trials. The article also reviews other possibilities that are either briefly or not discussed in the literature but could play a role in the fight against COVID-19.

scholarly journals Perioperative Management for Patients with Hereditary Angioedema

2015 ◽  
Vol 6 (1) ◽  
pp. ar.2015.6.0112 ◽  
Author(s):  
Anesu H. Williams ◽  
Timothy J. Craig
Keyword(s):  
Hereditary Angioedema ◽  
Perioperative Management ◽  
Action Plan ◽  
Treatment Options ◽  
Perioperative Period ◽  
The United States ◽  
Dental Procedures ◽  
Dominant Disease ◽  
Acute Attacks ◽  
Critical Patients

Hereditary angioedema (HAE) is a rare autosomal dominant disease that results from mutations in the C1-esterase inhibitor (C1-INH) gene. HAE is characterized by recurrent episodes of angioedema of the skin (face, extremities, genitalia, trunk), the gastrointestinal tract, and respiratory tract. Symptoms experienced can be debilitating, may impact quality of life, and can be life threatening. Preventing attacks particularly for patients undergoing procedures is critical. Patients with HAE may now treat acute attacks or prevent attacks with medications that have recently become available in the United States; however, these same medications can be used for perioperative management for patients undergoing medical, surgical, and dental procedures. Periprocedural planning is important for patients to reduce the incidence of acute attacks. Education is critical and increasing awareness of short-term prophylaxis options will allow providers to develop an appropriate action plan for their patients. The goal of this review is to increase awareness for HAE treating physicians, surgeons, anesthesia, and emergency room physicians by examining the available treatment options, researching the literature, and summarizing available data for periprocedural management. The availability of treatment options has increased over the past few years, expanding options for physicians and patients living with HAE and improve safety during the perioperative period and at the time of other procedures.

scholarly journals Phototherapy as a treatment of early-stage mycosis fungoides and predictive factors for disease recurrence: A 17-year retrospective study

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Ploysyne Rattanakaemakorn ◽  
Monthanat Ploydaeng ◽  
Siriorn Udompanich ◽  
Kunlawat Thadanipon ◽  
Suthinee Rutnin ◽  
...  
Keyword(s):  
Complete Remission ◽  
Effective Treatment ◽  
Median Time ◽  
Mycosis Fungoides ◽  
Predictive Factors ◽  
Early Stage ◽  
Treatment Options ◽  
Ultraviolet B ◽  
Disease Stage ◽  
Ultraviolet A

Background: Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Narrowband ultraviolet B and psoralen and ultraviolet A are effective treatment options, but studies of their treatment efficacy and disease relapse remain limited. Objectives: This study aimed (1) to determine the efficacy of narrowband ultraviolet B and psoralen and ultraviolet A as a treatment for early-stage mycosis fungoides and explore the predictive factors for complete remission and (2) to determine the relapse rate and analyze their predictive factors, including the utility of maintenance therapy. Methods: This was a retrospective cohort study consisting of 61 patients with early-stage mycosis fungoides (IA - IB) treated with narrowband ultraviolet B or psoralen and ultraviolet A as the first-line therapy from January 2002 to December 2018 at the Division of Dermatology, Ramathibodi Hospital, Bangkok, Thailand. Cox regression analysis and Kaplan–Meier survival curve were performed for the main outcomes. Results: A complete remission was achieved by 57 (93.5%) patients. The median time to remission was 7.80 ± 0.27 months. Types of phototherapy (narrowband ultraviolet B or psoralen and ultraviolet A), age and gender did not associate with time to remission, while the presence of poikiloderma and higher disease stage led to a longer time to remission. The cumulative incidence of relapse was 50.8%. The median time to relapse was 24.78 ± 5.48 months. In patients receiving phototherapy during the maintenance period, a treatment duration longer than six months was associated with a significantly longer relapse-free interval. Conclusion: Narrow-band-ultraviolet B and psoralen and ultraviolet A are effective treatment options for early-stage mycosis fungoides. Maintenance treatment by phototherapy for at least six months seems to prolong remission.

Benign Intracranial Lesions - Radiotherapy: An Overview of Treatment Options, Indications and Therapeutic Results

2020 ◽  
Vol 15 (2) ◽  
pp. 93-121
Author(s):  
Vasileios Tzikoulis ◽  
Areti Gkantaifi ◽  
Filippo Alongi ◽  
Nikolaos Tsoukalas ◽  
Haytham Hamed Saraireh ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Treatment Modality ◽  
Radiation Effects ◽  
Treatment Options ◽  
Proton Beam Therapy ◽  
Tumor Control ◽  
Control Growth ◽  
Effective Treatment Modality ◽  
Intracranial Lesions

Background: Radiation Therapy (RT) is an established treatment option for benign intracranial lesions. The aim of this study is to display an update on the role of RT concerning the most frequent benign brain lesions and tumors. Methods: Published articles about RT and meningiomas, Vestibular Schwannomas (VSs), Pituitary Adenomas (PAs), Arteriovenous Malformations (AVMs) and craniopharyngiomas were reviewed and extracted data were used. Results: In meningiomas RT is applied as an adjuvant therapy, in case of patientrefusing surgery or in unresectable tumors. The available techniques are External Beam RT (EBRT) and stereotactic ones such as Stereotactic Radiosurgery (SRS), Fractionated Stereotactic RT (FSRT), Intensity Modulated RT (IMRT) and proton-beam therapy. The same indications are considered in PAs, in which SRS and FSRT achieve excellent tumor control rate (92-100%), acceptable hormone remission rates (>50%) and decreased Adverse Radiation Effects (AREs). Upon tumor growth or neurological deterioration, RT emerges as alone or adjuvant treatment against VSs, with SRS, FSRT, EBRT or protonbeam therapy presenting excellent tumor control growth (>90%), facial nerve (84-100%), trigeminal nerve (74-99%) and hearing (>50%) preservation. SRS poses an effective treatment modality of certain AVMs, demonstrating a 3-year obliteration rate of 80%. Lastly, a combination of microsurgery and RT presents equal local control and 5-year survival rate (>90%) but improved toxicity profile compared to total resection in case of craniopharyngiomas. Conclusion: RT comprises an effective treatment modality of benign brain and intracranial lesions. By minimizing its AREs with optimal use, RT projects as a potent tool against such diseases.

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