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Dr. Grey AI

Peptide

Icatibant (Firazyr)

Icatibant is a synthetic decapeptide and selective bradykinin B2 receptor antagonist. FDA-approved in 2011 for acute hereditary angioedema (HAE) attacks. Phase III FAST trials showed median symptom relief in 2 hours vs 12-19.8 hours placebo/comparator. Administered as 30mg subcutaneous injection, self-injectable by patients.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
7
Graded outcomes
5101

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Hereditary Angioedema

Hereditary Angioedema: outcomes studied for Icatibant (Firazyr)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Cutaneous Attack Resolution

Rapid and stable relief from cutaneous attacks demonstrated in Phase III trials.

Improves (the measure goes up)Large effect18 studies

Studies that measured cutaneous attack resolution

and 8 more in the citations list

Abdominal Attack Resolution

Significant reduction in abdominal attack symptoms with rapid onset of action.

Improves (the measure goes up)Large effect18 studies

Studies that measured abdominal attack resolution

and 8 more in the citations list

Laryngeal Attack Resolution

Effective for potentially life-threatening laryngeal attacks, though emergency medical care still recommended.

Improves (the measure goes up)Large effect18 studies

Studies that measured laryngeal attack resolution

and 8 more in the citations list

Time to Symptom Relief

FAST-3: 2.0 hours to 50%+ symptom reduction vs 19.8 hours placebo (P<0.001). FAST-2: 2.0 hours vs 12.0 hours tranexamic acid (P<0.001).

Improves (the measure goes down)Large effect16 studies

Studies that measured time to symptom relief

and 6 more in the citations list

Primary Symptom Relief Onset

FAST-3: Median onset of primary symptom relief 1.5 hours vs 18.5 hours placebo (P<0.001).

Improves (the measure goes down)Large effect16 studies

Studies that measured primary symptom relief onset

and 6 more in the citations list

General

General: outcomes studied for Icatibant (Firazyr)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Safety/Tolerability

5 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect8 studies

Studies that measured safety/tolerability

Reproductive Outcomes

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect5 studies

Studies that measured reproductive outcomes

Key findings

  • Cutaneous Attack ResolutionHereditary AngioedemaImproves (the measure goes up)
  • Abdominal Attack ResolutionHereditary AngioedemaImproves (the measure goes up)
  • Laryngeal Attack ResolutionHereditary AngioedemaImproves (the measure goes up)

Studies cited

24 studies from PubMed

  1. Safety, efficacy, and pharmacokinetics of icatibant treatment in Japanese pediatric patients with hereditary angioedema: A phase 3, open-label study.The Journal of dermatology, 2023 · PMID 37381768
  2. Three-Day Icatibant on Top of Standard Care in Patients With Coronavirus Disease 2019 Pneumonia: A Randomized, Open-Label, Phase 2, Proof-of-Concept Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 · PMID 36610464
  3. Is Icatibant Safe for the Treatment of Hereditary Angioedema During Pregnancy?Current allergy and asthma reports, 2022 · PMID 36044174
  4. A multicenter, open-label, randomized, proof-of-concept phase II clinical trial to assess the efficacy and safety of icatibant in patients infected with SARS-CoV-2 (COVID-19) and admitted to hospital units without invasive mechanical ventilation: study protocol (ICAT-COVID).Trials, 2022 · PMID 35413921
  5. Efficacy, pharmacokinetics, and safety of icatibant for the treatment of Japanese patients with an acute attack of hereditary angioedema: A phase 3 open-label study.Allergology international : official journal of the Japanese Society of Allergology, 2020 · PMID 31672405
  6. Icatibant, another piece of the therapeutic puzzle regarding hemodynamic side effects of angiotensin-converting enzyme inhibitors.Critical care (London, England), 2019 · PMID 31462265
  7. Effect of icatibant on angiotensin-converting enzyme inhibitor-induced angioedema: A meta-analysis of randomized controlled trials.Journal of clinical pharmacy and therapeutics, 2019 · PMID 31290163
  8. Self-administration of icatibant in acute attacks of Type I hereditary angioedema: A case report and review of hereditary angioedema.Dermatologic therapy, 2019 · PMID 31579975
  9. Long-term safety of icatibant treatment of patients with angioedema in real-world clinical practice.Allergy, 2017 · PMID 27926986
  10. Icatibant outcome survey: patient experience with hereditary angioedema treatmentAllergy Asthma Clin Immunol, 2015 · PMID 26449536
  11. Icatibant Exposure During Pregnancy in a Patient With Hereditary Angioedema.Journal of investigational allergology & clinical immunology, 2015 · PMID 26817146
  12. [Prophylactic use of icatibant before tracheal intubation of a patient with hereditary angioedema type III. (A literature review of perioperative management of patients with hereditary angioedema type III)].Revista espanola de anestesiologia y reanimacion, 2014 · PMID 24931134
  13. Icatibant for the treatment of hereditary angioedemaExpert Opin Pharmacother, 2013 · PMID 23249729
  14. A review of icatibant for the treatment of hereditary angioedemaImmunotherapy, 2013 · PMID 24219790
  15. [Administration of conestat alfa, human C1 esterase inhibitor and icatibant in the treatment of acute angioedema attacks in adults with hereditary angioedema due to C1 esterase inhibitor deficiency. Treatment comparison based on systematic review results].Pneumonologia i alergologia polska, 2013 · PMID 23420425
  16. Randomized placebo-controlled trial of the bradykinin B₂ receptor antagonist icatibant for the treatment of acute attacks of hereditary angioedema: the FAST-3 trialAnn Allergy Asthma Immunol, 2011 · PMID 22123383
  17. Successful long-term treatment with the bradykinin B2 receptor antagonist icatibant in a patient with hereditary angioedemaEur Ann Allergy Clin Immunol, 2011 · PMID 21950301
  18. Icatibant: first global approvalDrugs, 2011 · PMID 21939553
  19. Icatibant (Firazyr®) for the treatment of acute attacks in hereditary angioedemaDrugs, 2011 · PMID 22607911
  20. Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedemaN Engl J Med, 2010 · PMID 20818888
  21. Icatibant for hereditary angioedemaN Engl J Med, 2010 · PMID 20135020
  22. Successful treatment of hereditary angioedema with bradykinin B2-receptor antagonist icatibantAllergy, 2009 · PMID 19758369
  23. Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant)J Allergy Clin Immunol, 2007 · PMID 17418383
  24. Novel pharmacotherapy of acute hereditary angioedema with bradykinin B2-receptor antagonist icatibantAnn Allergy Asthma Immunol, 2006 · PMID 17073887