454 Efficacy of Icatibant Versus Fresh Frozen Plasma for Attacks of Hereditary Angioedema: Analysis of Indivudual Symptoms by Attack Site

BACKGROUND: Hereditary angioedema (HAE) is a rare disorder characterized by funcional deficiency of C1 inhibitor (C1-INH) resulting in unpredictable, acute swelling attacks at varied locations. Icatibant, a selective bradikinin B2 receptor antagonist, is a novel treatment for acute attacks of HAE. The aim of the present study was to compare the efficacy beteween icatibant and fresh frozen plasma (FFP) in the acute attacks of HAE. METHODS: We performed a retrospective analysis of acute attacks of HAE in a tertiary hospital. We compared the efficacy of icatibant with fresh frozen plasma as control group. Efficacy was measured as the median time to onset of symptoms relief and the improvement of HAE and the median time to end of the attacks. Safety was assessed in terms of adverse events. All participants gave written informed consent. RESULTS: There were 21 acute attacks, 14 for icatibant and 7 for FFP. The median time to onset of symptoms relief was 27 and 45 minutes for icatibant and FFP respectively (P = 0.106). The median time to complete resolution of all simptoms was 240 and 2880 minutes respectively for icatibant and FFP (P = 0.002). All patients with Icatibant experienced generally mild transient injection-site reactions (erythema and swelling, and pain) wich resolved spontaneously without intervention. No drug-related serious adverse events were observed with icatibant and administration of FFP was not associated with infections of human inmunodeficiency virus, or hepatitis virus. CONCLUSIONS: Icatibant was effective and generally well tolerated, providing rapid regression of symptoms associated with acute HAE attacks at all anatomic sites.