@article {Longhurst:2015:1088-5412:399,
title = "Analysis of characteristics associated with reinjection of icatibant: Results from the Icatibant Outcome Survey",
journal = "Allergy and Asthma Proceedings",
parent_itemid = "infobike://ocean/aap",
publishercode ="ocean",
year = "2015",
volume = "36",
number = "5",
publication date ="2015-09-01T00:00:00",
pages = "399-406",
itemtype = "ARTICLE",
issn = "1088-5412",
eissn = "1539-6304",
url = "https://www.ingentaconnect.com/content/ocean/aap/2015/00000036/00000005/art00016",
doi = "doi:10.2500/aap.2015.36.3892",
keyword = "treatment, icatibant, acute attacks, hereditary angioedema, C1-inhibitor deficiency, observational, reinjection, bradykinin B2 receptor antagonist, real-world",
author = "Longhurst, Hilary J. and Aberer, Werner and Bouillet, Laurence and Caballero, Teresa and Fabien, Vincent and Zanichelli, Andrea and Maurer, Marcus and The IOS Study Group and Aberer, W. and Bygum, A. and Delaunay, C. Blanchard and Boccon-Gibod, I. and Bouillet, L. and Fain, O. and Gompel, A. and Guez, S. and Jeandel, P.Y. and Kanny, G. and Launay, D. and Maillard, H. and Martin, L. and Masseau, A. and Ollivier, Y. and Ba, M. and Bork, K. and Maurer, M. and Psarros, F. and Graif, Y. and Toubi, E. and Bova, M. and Arcoleo, F. and Marone, G. and Montinaro, V. and Zanichelli, A. and Baeza, M.L. and Caballero, T. and Guilarte, M. and Hern{\’a}ndez Fernandez de Rojas, D. and Hernando de Larramendi, C. and Lleonart, R. and Marqu{\’e}s, L. and Bjoerkander, J. and Helbert, M. and Longhurst, H.",
abstract = "
Purpose:
Phase 3 icatibant trials showed that most hereditary angioedema (HAE) (C1 inhibitor deficiency) acute attacks were treated successfully with one injection of icatibant, a selective bradykinin B2 receptor antagonist. We conducted a post hoc analysis of icatibant reinjection
for HAE type I and II attacks in a real-world setting by using data from the Icatibant Outcome Survey, an ongoing observational study that monitors the safety and effectiveness of icatibant treatment. 
Methods:
Descriptive retrospective analyses of icatibant reinjection
were performed on Icatibant Outcome Survey data (February 2008 to December 2012). New attacks were defined as the onset of new symptoms after full resolution of the previous attack. Potential associations between the patient and attack characteristics and reinjection were explored by using
logistic regression analysis. 
Results:
Icatibant was administered for 652 attacks in 170 patients with HAE type I or II. Most attacks (89.1%) were treated with a single icatibant injection. For attacks that required two or three injections, the second injection was given
a median of 11.0 hours after the first injection, with 90.4% of second injections administered 6 hours after the first injection. Time to resolution and attack duration were significantly longer for two or three injections versus one icatibant injection (p < 0.0001 and p < 0.05,
respectively). Multivariate logistic regression analysis identified sex, attack severity, and laryngeal attacks as significantly correlated with reinjection (all p 0.05). These factors did not remain predictors for reinjection when two outlier patients with distinct patterns of icatibant
use were excluded. 
Conclusions:
In this real-world setting, most HAE attacks resolved with one icatibant injection. There was no distinct profile for patients or attacks that required reinjection when outliers with substantially different patterns of use were excluded.
Because new attacks were not distinguished from the recurrence of symptoms, reinjection rates may be slightly higher than shown here. Clinical trial identifier: NCT01034969",
}