Publications

Background: Icatibant is a bradykinin B2-receptor antagonist used for the treatment of hereditary angioedema attacks resulting from C1-inhibitor de ciency. Treatment is not adjusted by body weight however the impact of body mass index (BMI) on the e ectiveness of icatibant is not documented in the literature. We examined disease charac- teristics and icatibant treatment e ectiveness in patients strati ed by BMI in the Icatibant Outcome Survey, an ongo- ing, international, observational study monitoring the real-world safety and e ectiveness of icatibant.

Methods: Attack and treatment characteristics as well as outcomes following treatment with icatibant were com- pared among patients with underweight, normal, overweight, and obese BMI.

Results: Data from 2697 icatibant-treated attacks in 342 patients (3.5, 44.7, 34.8, and 17.0% patients of underweight, normal, overweight, and obese BMI, respectively) were analyzed. There was no signi cant di erence in the frequency and severity of attacks across BMI groups, although obese patients tended to have more attacks of high severity. There was no impact of BMI on the frequency of laryngeal attacks, but patients with normal BMI had fewer cutaneous attacks and more abdominal attacks. Most attacks (71.9–83.8%) were treated with a single icatibant injection without the need for rescue with plasma-derived C1-inhibitor (pdC1-INH), regardless of BMI. Patients with obese BMI used pdC1-INH as rescue treatment more often (P < 0.0001; P = 0.0232 excluding 2 outliers) and treated attacks earlier than patients with normal BMI (P = 0.007). Furthermore, time to resolution and duration of attack were shorter for patients with high BMI (P < 0.001 for overweight and P < 0.05 for obese versus normal).

Conclusion: Overall, icatibant was comparatively e ective in treating attacks in patients across all BMI groups. Trial registration NCT01034969.