Researchers from Croatia presented their experience in using icatibant to treat a pregnant patient with hereditary angioedema in a review published in the journal Current Allergy and Asthma Reports

“Considering the limited number of attacks that our patient usually experiences, which continued at more or less the same frequency during pregnancy, we feel icatibant to be a safe choice for on-demand [hereditary angioedema] treatment during pregnancy for such cases,” the researchers wrote.

Hereditary angioedema can be treated with plasma-derived or human-recombinant C1-inhibitor, icatibant, or ecallantide. Because there is a lack of knowledge and experience in using these in pregnant women, the treatment of choice in pregnant women with the disease is plasma-derived C1-inhibitor.


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Read more about the treatment of hereditary angioedema

The case presented here is that of a woman, age 23 who had her first angioedema attack at age 16 and was later diagnosed with hereditary angioedema. After she turned 18, she was treated with icatibant or human-recombinant C1-inhibitor as needed. 

The patient became pregnant at age 22 and had 4 angioedema attacks during her pregnancy and 1 during labor. She was treated with icatibant in each case. She gave birth at 40 weeks and had 2 more angioedema attacks 4 months later and another 6 months after the birth of her baby.

Since icatibant treatment led to no adverse effects or abnormalities, the authors of the study concluded that the treatment is safe and effective in pregnant women. They added that the frequency of the attacks should be the key deciding factor on which treatment to choose.

Icatibant, marketed under the brand name Firazyr®, is a selective bradykinin B2-receptor antagonist. It was shown to be safe and effective in 3 randomized clinical trials and has been approved by the US Food and Drug Administration. There have been no controlled studies about the use of icatibant during pregnancy.

Reference

Šimac DV, Štimac T, Novak S. Is icatibant safe for the treatment of hereditary angioedema during pregnancy? Curr Allergy Asthma Rep. Published online August 31, 2022. doi:10.1007/s11882-022-01040-3