{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:55:11Z","timestamp":1767866111166,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Angioedema is a potentially life\u2010threatening complication of angiotensin\u2010converting enzyme inhibitor (ACEI) use, occurring in up to 0.5% of users. Although the pathophysiology of ACEI\u2010induced angioedema is attributable to elevated serum bradykinin, standard management typically includes corticosteroids and antihistamines. We sought to summarize the evidence supporting pharmacotherapy for ACEI\u2010induced angioedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, MEDLINE, and Embase portals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature review was conducted according to the PRISMA guidelines. Databases were queried by 3\u00a0independent reviewers for English\u2010language studies published between 1980 and 2017. The initial search screened for all occurrences of \u201cangioedema\u201d and then was further refined to include studies of ACEI\u2010related cases and exclude hereditary angioedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five articles representing 218 cases were identified, including 3 randomized controlled trials and 2 prospective case series with historical controls. One of 2 studies of icatibant (bradykinin B2 receptor antagonist) found more rapid symptom improvement than that with a control group of corticosteroids and antihistamines. Two studies of ecallantide (plasma kallikrein inhibitor) and 1 study of C1\u00a0inhibitor replacement found no significant benefit over control. No studies were identified that compared the efficacy of corticosteroids with antihistamines, of one dose with another, of fresh frozen plasma, or of combination therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The efficacy of treatment of ACEI\u2010induced angioedema with bradykinin antagonists, kallikrein inhibitor, and C1\u00a0inhibitor warrants further study. Although consistent benefit of these medications has not been demonstrated, their use has not caused harm. One study examining off\u2010label use of icatibant has demonstrated efficacy over control. In addition, further study is needed to establish the efficacy and mechanism of action of standard pharmacotherapy such as corticosteroids and antihistamines in treatment of this condition.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817737974","type":"journal-article","created":{"date-parts":[[2017,12,31]],"date-time":"2017-12-31T06:24:01Z","timestamp":1514701441000},"page":"232-239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Pharmacotherapy for Angiotensin\u2010Converting Enzyme Inhibitor\u2013Induced Angioedema: A Systematic Review"],"prefix":"10.1002","volume":"158","author":[{"given":"Claire M.","family":"Lawlor","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Tulane University New Orleans Louisiana 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