Treatment with icatibant in the management of drug induced angioedema

Ac ut e, dr ug-induc ed angioe dem a may no t resp ond to stan dard th er apie s, because the pa thog ene tic mec han ism th at induce s the patho log y is not al ways mediated by hist ami ne but, in certa in inst ance s, by bradykinin. A case of ang io edema is rep orte d here , in wh ich al lergic eti olo gy was ex clud ed by the non-r espon se to anti his tami nes. Co nsi derin g the clinic al history (repeated use of dru gs) an d the ineff ect iveness of st an dar d th erapy , it wa s decid ed to ad mi nister a beta2 rec eptor antago ni st, icatibant. After 20 minu te s, the patie nt re port ed a subject ive im- provement . Th e only form of angi oedema for whi ch th is typ e of me dic atio n is licen sed is the her edi tary def icie nc y of C1 in hibi tor . The use of icati ban t for th e trea tmen t of other typ es of an - gio ed ema (wh ic h can also be li fe-saving if the air wa y is inv olved) is off la be l. The off-label use of a dr ug is allow ed in the abs en ce of a viable al - ternati ve th erap y, if the re is sc ien tific evid enc e in the literat ure and if th e presc ribe r tak es respon - sibil ity. The case here rep orted dr aw s atten tio n to th is therapeu tic pro ble m an d unde rlines the fact that a li fe-t hreate nin g emer gen cy can just ify the use of icat i