Longhurst Hilary J
Department of Immunology, Barts and The London NHS Trust, London, UK.
Vasc Health Risk Manag. 2010 Sep 7;6:795-802. doi: 10.2147/vhrm.s4332.
Icatibant (Firazyr(®)) is a novel subcutaneous treatment recently licensed in the European Union for acute hereditary angioedema. Hereditary angioedema, resulting from inherited partial C1 inhibitor deficiency, is a disabling condition characterized by intermittent episodes of bradykinin-mediated angioedema. Icatibant blocks bradykinin B2 receptors, attenutating the episode. Randomized double-blind, placebo-controlled trials of icatibant, showed significant superiority over oral tranexamic acid in 74 European patients and a trend to improvement in a similar US trial comparing icatibant with placebo in 55 patients. Outcomes for several endpoints did not reach significance in the US trial, perhaps because of low participant numbers and confounding factors: a further trial is planned. Open label studies have shown benefit in multiple treatments for attacks at all sites. Approximately 10% of patients require a second dose for re-emergent symptoms, usually 10 to 27 hours after the initial treatment. Its subcutaneous route of administration, good tolerability and novel mode of action make icatibant a promising addition to the limited repertoire of treatments for hereditary angioedema.
依卡替班（飞泽优（Firazyr(®)））是一种新型皮下注射治疗药物，最近在欧盟获批用于治疗急性遗传性血管性水肿。遗传性血管性水肿是由遗传性部分C1抑制剂缺乏引起的一种致残性疾病，其特征为缓激肽介导的血管性水肿间歇性发作。依卡替班可阻断缓激肽B2受体，从而减轻发作症状。依卡替班的随机双盲、安慰剂对照试验表明，在74名欧洲患者中，其疗效显著优于口服氨甲环酸；在一项针对55名患者的美国类似试验中，将依卡替班与安慰剂进行比较，也显示出改善趋势。在美国的试验中，几个终点指标的结果未达到显著差异，这可能是由于参与人数较少和存在混杂因素所致：计划进行进一步试验。开放标签研究表明，依卡替班对各个部位发作的多种治疗均有效果。约10%的患者因症状复发需要注射第二剂，通常在初始治疗后10至27小时。依卡替班的皮下给药途径、良好的耐受性和新颖的作用方式使其成为遗传性血管性水肿有限治疗方法中的一个有前景的补充药物。
