ANGIOEDEMA WITHOUT URTICARIA – Treatment
Treatment for special types of angioedema without urticaria is completely different from the urticaria treatment, because since they are caused by bradykinin, they respond neither to anti-histamines or corticosteroids nor to adrenaline. That’s why providing an accurate diagnosis is so important for implementing the right therapy.
For being a disease that can be life-threatening in some cases, drug therapy is divided into prophylactic – to avoid new episodes, and symptomatic – to treat acute flares.
Not all drugs are available everywhere. Each country has particular regulations in what concerns to drugs for treating angioedema without urticaria.
In this section, we will discuss about the drugs that are globally available and what are they used for. Your doctor will be able to consider and select the best therapy option at the right moment.
Drugs are targeted to increase the levels of C1 inhibitor or to block bradykinin activity. These drugs are approved only for use in hereditary angioedema, but they can also be used for other types, according to medical staff’s level of experience with them.
Treating flares (acute)
Treatment must be provided in a specialized site, e.g., in a hospital. The first measure is to provide hydration to control blood pressure and keep the patient breathing.
Medications that may be used:
- C1 Inhibitor (INH-C1) – derived from human plasma (replaces the inhibitor)
- Bradykinin receptor antagonist
- Selective calycrein inhibitor
- Human plasma: employed when the above medications are not available; inhibitor replacement
The intention here is to avoid flares. This type of therapy is preferred when the patient experiences frequent or very serious flares (life-threatening, when affecting breathing) or when a surgical procedure is prescribed.
The following are used:
- Attenuated androgens – enhance C1 inhibitor activity
- Antifibrinolytic drugs
- Tranexamic acid
- Epsilon aminocaproic acid (EACA)
For angioedema caused by angiotensin converting enzyme inhibitor, switching medications to drugs of different groups is necessary. And, in acquired angioedema, the implementation of therapy for the underlying disease is recommended whenever possible.
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