Angioedema induced by cardiovascular drugs: new players join old friends
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- M. Bas
- Otorhinolaryngology Department University Hospital Rechts der Isar Munich Technical University Munich Germany
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- J. Greve
- Department of Oto‐Rhino‐Laryngology, Head and Neck Surgery Ulm University Medical Center Ulm Germany
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- U. Strassen
- Otorhinolaryngology Department University Hospital Rechts der Isar Munich Technical University Munich Germany
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- F. Khosravani
- Institute of Pharmacology and Clinical Pharmacology Heinrich Heine University Düsseldorf Germany
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- T. K. Hoffmann
- Department of Oto‐Rhino‐Laryngology, Head and Neck Surgery Ulm University Medical Center Ulm Germany
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- G. Kojda
- Institute of Pharmacology and Clinical Pharmacology Heinrich Heine University Düsseldorf Germany
抄録
<jats:title>Abstract</jats:title><jats:p>During the last years, two new cardiovascular drug classes, namely inhibitors of <jats:styled-content style="fixed-case">DPP IV</jats:styled-content> or neprilysin, have been developed. In both cases, there is clinical evidence for their potential to induce angioedema as known already from blockers of the renin–angiotensin–aldosterone system (<jats:styled-content style="fixed-case">RAAS</jats:styled-content>). The majority of angioedema induced by <jats:styled-content style="fixed-case">DPP IV</jats:styled-content> inhibitors occurs during concomitant treatment with <jats:styled-content style="fixed-case">ACE</jats:styled-content>i and is therefore likely mediated by overactivation of bradykinin type 2 receptors (B2). In striking contrast, the molecular pathways causing angioedema induced by neprilysin inhibitors, that is, sacubitril, are unclear, although a contribution of bradykinin appears likely. Nevertheless, there is no clinical evidence suggesting that inhibition of B2 might relieve the symptoms and/or prevent invasive treatment including coniotomy or tracheotomy in angioedema caused by these drugs. Therefore, the risk of angioedema should always be considered, especially in ambulatory care situations where patients have no rapid access to intensive care.</jats:p>
収録刊行物
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- Allergy
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Allergy 70 (10), 1196-1200, 2015-07-15
Wiley