Subcutaneous Icatibant for the Treatment of Hereditary Angioedema Attacks: Comparison of Home Self-Administration with Administration at a Medical Facility

Iris M. Otani, William R. Lumry, Shelley Hurwitz, Huamin Li, Timothy J. Craig, Niki S. Holtzman, Matthew I. Iandoli, Julie Tucker, Marc A. Riedl, Bruce L. Zuraw, Aleena Banerji

Research output: Contribution to journalArticle

Abstract

Background: Hereditary angioedema (HAE) is a life-threatening disorder characterized by recurrent angioedema. Icatibant, a subcutaneous bradykinin-B2-receptor antagonist, is an effective on-demand therapy. Data outside the United States suggest that self-administration is tolerated and patient-preferred compared with administration by health care professionals at medical facilities (HCP-administration). Objective: A prospective, multicenter study was conducted in the United States to compare icatibant self-administration and HCP-administration. Methods: Subjects 18 years or older with type I or II HAE were recruited. The first 2 HAE attacks after enrollment were treated at medical facilities. Subjects were instructed by a health care professional on self-administration during icatibant treatment for the second HAE attack. Icatibant was self-administered for all subsequent attacks. For each treated HAE attack, efficacy, safety, and tolerability data were recorded. Results: Nineteen patients with HAE received icatibant for 79 distinct HAE attacks. Mean attack duration was significantly shorter with self-administration (n = 50; 547 ± 510 minutes) than with HCP-administration (n = 29; 968 ± 717 minutes; . P = .006). Mean time to treatment was significantly shorter with self-administration (143 ± 226 minutes) than with HCP-administration (361 ± 503 minutes; . P < .0001). Shorter times to treatment were associated with shorter time from treatment to symptom resolution (r = 0.35; . P = .02). Improvements in visual analog scale score and patient symptom score from pretreatment to 4 hours postinjection were comparable between self-administration and HCP-administration. There were no serious adverse events or discontinuations due to adverse events with self-administration or HCP-administration. Conclusions: Icatibant self-administration shortened attack duration and time to treatment, with no difference in safety or local tolerability compared with HCP-administration. These findings support icatibant as an effective on-demand option for home-based treatment.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StateAccepted/In press - Jun 23 2016
Externally publishedYes

Fingerprint

Hereditary Angioedemas
Self Administration
Therapeutics
Hereditary Angioedema Types I and II
Delivery of Health Care
Safety
Angioedema
icatibant
Visual Analog Scale
Multicenter Studies
Prospective Studies

Keywords

  • Bradykinin-receptor antagonist
  • Hereditary angioedema
  • Home-based treatment
  • Icatibant

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Subcutaneous Icatibant for the Treatment of Hereditary Angioedema Attacks : Comparison of Home Self-Administration with Administration at a Medical Facility. / Otani, Iris M.; Lumry, William R.; Hurwitz, Shelley; Li, Huamin; Craig, Timothy J.; Holtzman, Niki S.; Iandoli, Matthew I.; Tucker, Julie; Riedl, Marc A.; Zuraw, Bruce L.; Banerji, Aleena.

In: Journal of Allergy and Clinical Immunology: In Practice, 23.06.2016.

Research output: Contribution to journalArticle

Otani, Iris M. ; Lumry, William R. ; Hurwitz, Shelley ; Li, Huamin ; Craig, Timothy J. ; Holtzman, Niki S. ; Iandoli, Matthew I. ; Tucker, Julie ; Riedl, Marc A. ; Zuraw, Bruce L. ; Banerji, Aleena. / Subcutaneous Icatibant for the Treatment of Hereditary Angioedema Attacks : Comparison of Home Self-Administration with Administration at a Medical Facility. In: Journal of Allergy and Clinical Immunology: In Practice. 2016.
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abstract = "Background: Hereditary angioedema (HAE) is a life-threatening disorder characterized by recurrent angioedema. Icatibant, a subcutaneous bradykinin-B2-receptor antagonist, is an effective on-demand therapy. Data outside the United States suggest that self-administration is tolerated and patient-preferred compared with administration by health care professionals at medical facilities (HCP-administration). Objective: A prospective, multicenter study was conducted in the United States to compare icatibant self-administration and HCP-administration. Methods: Subjects 18 years or older with type I or II HAE were recruited. The first 2 HAE attacks after enrollment were treated at medical facilities. Subjects were instructed by a health care professional on self-administration during icatibant treatment for the second HAE attack. Icatibant was self-administered for all subsequent attacks. For each treated HAE attack, efficacy, safety, and tolerability data were recorded. Results: Nineteen patients with HAE received icatibant for 79 distinct HAE attacks. Mean attack duration was significantly shorter with self-administration (n = 50; 547 ± 510 minutes) than with HCP-administration (n = 29; 968 ± 717 minutes; . P = .006). Mean time to treatment was significantly shorter with self-administration (143 ± 226 minutes) than with HCP-administration (361 ± 503 minutes; . P < .0001). Shorter times to treatment were associated with shorter time from treatment to symptom resolution (r = 0.35; . P = .02). Improvements in visual analog scale score and patient symptom score from pretreatment to 4 hours postinjection were comparable between self-administration and HCP-administration. There were no serious adverse events or discontinuations due to adverse events with self-administration or HCP-administration. Conclusions: Icatibant self-administration shortened attack duration and time to treatment, with no difference in safety or local tolerability compared with HCP-administration. These findings support icatibant as an effective on-demand option for home-based treatment.",
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AU - Hurwitz, Shelley

AU - Li, Huamin

AU - Craig, Timothy J.

AU - Holtzman, Niki S.

AU - Iandoli, Matthew I.

AU - Tucker, Julie

AU - Riedl, Marc A.

AU - Zuraw, Bruce L.

AU - Banerji, Aleena

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