{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:19:08Z","timestamp":1747149548433,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>C1\u2010inhibitor (C1INH) concentrates and the selective bradykinin B2 receptor antagonist icatibant are approved only for treating hereditary angioedema with C1INH deficiency. Yet, they are regularly prescribed off label in other types of bradykinin\u2010mediated angioedema including angiotensin\u2010converting enzyme inhibitor (ACEi)\u2010related and undetermined angioedema.<\/jats:p><jats:p>We conducted a retrospective chart review of inpatient prescriptions of C1INH concentrates and icatibant between 2016 and 2020 in the University Hospital of Angers. The first outcome was the proportion of prescriptions with explicit indication. Then, we determined the compliance of prescriptions with European Medicines Agency approvals and the French bradykinin\u2010mediated angioedema reference center guidelines. Finally, we estimated the economic impact of inappropriate prescribing.<\/jats:p><jats:p>The therapeutic indication was explicit in 90.4% of prescriptions (n\u00a0=\u00a066\/73). Only 17.8% of prescriptions were for hereditary angioedema with C1INH deficiency, while 31.5% were for ACEi\u2010related and 28.7% for undetermined angioedema. However, most off\u2010label prescriptions were consistent with the French bradykinin\u2010mediated angioedema reference center guidelines (73.3%). We estimated that 13% of drug expenditures were potentially excessive.<\/jats:p><jats:p>The predominance of off\u2010label prescriptions may be explained by the infrequency of hereditary angioedema and the absence of approved alternatives in other types of bradykinin\u2010mediated angioedema. Most attacks were related to ACEis. Epinephrine was rarely prescribed as first\u2010line therapy in attacks of unknown origin. Given the high prices of these drugs, we advocate the development of a readily available management algorithm of angioedema to reduce inappropriate prescriptions in our center. In addition, we think that the drug prescription circuit should be redesigned to ensure the traceability of prescribed vials in the dispensing areas.<\/jats:p>","DOI":"10.1002\/jcph.2125","type":"journal-article","created":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T09:07:55Z","timestamp":1658653675000},"page":"29-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Large Predominance of Off\u2010Label Prescriptions of C1\u2010Inhibitor Concentrates and Icatibant in a Real\u2010Life Setting: A Retrospective Clinical Study"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0998-9786","authenticated-orcid":false,"given":"Samuel","family":"Rocour","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital of Angers  Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baptiste","family":"Cochard","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University Hospital of Angers  Angers France"},{"name":"School of Pharmacy Health Faculty University of Angers  Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rie","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University Hospital of Angers  Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovic","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Angers  Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Corvaisier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University Hospital of Angers  Angers France"},{"name":"School of Pharmacy Health Faculty University of Angers  Angers France"},{"name":"A4638 Laboratory of Psychology of the Pays de la Loire University of Angers  Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13384"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12380"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-019-0376-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710-1492-6-14"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-018-0859-x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60594-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12680"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12341"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-016-8585-0"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2018.06.015"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1312524"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.09.051"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.03.003"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2012.12.017"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000446"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2015.01.005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-020-00493-3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15241"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.11.014"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13090"},{"key":"e_1_2_9_22_1","unstructured":"HAS.Evaluation par classe des m\u00e9dicaments antihypertenseurs. 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