Icatibant Is Effective in Patients with ACE-Inhibitor–Induced Angioedema

Icatibant (Firazyr; a selective bradykinin B₂–receptor antagonist) is FDA approved for treating patients with hereditary angioedema (HAE). Like HAE, angioedema caused by angiotensin-converting–enzyme (ACE) inhibitors is bradykinin-mediated. Standard treatment with corticosteroids and antihistamines — drugs typically directed at mast cell–mediated angioedema — do not benefit patients with ACE-inhibitor–induced angioedema. In theory, icatibant should be effective for ACE-inhibitor–induced angioedema, which occasionally results in airway obstruction and need for intubation.

In a German trial partially funded by industry, 27 adults who presented within 10 hours of onset of ACE-inhibitor–induced angioedema of the upper aerodigestive tract (i.e., …