1. Effectiveness of C1-INH therapy in angiotensin converting enzyme inhibitor induced angioedema.
- Author
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Kovaltchouk, Uliana, Zhang, Boyang, Jain, Vipul, and Kalicinsky, Chrystyna
- Subjects
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ANGIONEUROTIC edema , *ACE inhibitors , *OFF-label use (Drugs) - Abstract
Introduction: Angiotensin Converting Enzyme Inhibitors (ACEI) are a common cause of Emergency Room presentation for angioedema. Although no treatment guidelines exist, C1 esterase inhibitor concentrate (C1-INH) is used on an off label basis for management of ACEI acquired angioedema (ACEI AAE). Objective: To evaluate the efficacy of C1-INH in management of ACEI AAE at our local centers. Results: Nine patients, from 3 academic sites, were identified through Allergy Service consultation data and records from Diagnostic Services Manitoba, Canada from 2010–2020. The majority of the patients (n = 8/9) required endotracheal intubation prior to the initiation of C1-INH. Overall, approximately 56% of patients (n = 5/9) had resolution of angioedema ranging between 12 and 17 h, with a median time of 13.5 h, and no recurrence after the administration of C1-INH concentrate. One patient had transient symptom resolution in 14 h, however, recurrence of angioedema required re-intubation. The remainder of patients (n = 4/9), had resolution of angioedema between 22 and 72 h, with a median time of 33.75 h. Conclusion: Our findings demonstrate continued ambivalence of the efficacy and role of C1-INH concentrate in the treatment of ACEI AAE, secondary to multiple uncontrolled confounding factors. Further research into characterizing a subgroup of intubated patients in our study that responded to C1-INH concentrate needs to be completed. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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