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Treatment to protect the airway may include intubation or cricothyroidotomy. [1] Histamine-related angioedema can be treated with antihistamines, corticosteroids, and epinephrine. [1] In those with bradykinin-related disease a C1 esterase inhibitor, ecallantide, or icatibant may be used. [1] Fresh frozen plasma may be used instead. [1]
Treatment of acquired angioedema is separated into two main parts. First controlling acute symptoms during angioedema attacks is crucial for preventing and lowering the risk of mortality. [20] Second, managing AAE chronically with prophylactic treatment is important to improve prognosis and quality of life. [20]
Ecallantide (trade name Kalbitor) is a drug used for the treatment of hereditary angioedema (HAE) and in the prevention of blood loss in cardiothoracic surgery. [2] It is an inhibitor of the protein kallikrein and a 60-amino acid polypeptide which was developed from a Kunitz domain through phage display to mimic antibodies inhibiting kallikrein.
Garadacimab is an experimental human monoclonal antibody under investigation for the treatment of hereditary angioedema. [1] Garadacimab is a monoclonal antibody against the activated coagulation factor XIIa (FXIIa), with potential anti-inflammatory and anticoagulant activities. [2] [3]
In October 2010, the European Medicines Agency authorized conestat alfa (brand name Ruconest), a C1-inhibitor for the treatment of acute angioedema attacks. [46] Icatibant (marketed as Firazyr) is a selective bradykinin receptor antagonist, was authorized in the EU in July 2008, [47] [48] and was approved in the US in August 2011. [38]
Edema may be described as pitting edema, or non-pitting edema. [32] Pitting edema is when, after pressure is applied to a small area, the indentation persists after the release of the pressure. Peripheral pitting edema, as shown in the illustration, is the more common type, resulting from water retention.
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