Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema

Abstract Background Angioedema (AE) rarely occurs as a potentially life‐threatening adverse drug reaction (ADR) to angiotensin‐converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). The aim of the present study was to investigate non‐genetic association factors with ACEi‐/ARB‐in...

Full description

Saved in:
Bibliographic Details
Main Authors: Diana Dubrall, Nora L. Branding, Carina M. Mathey, Anna M. Weber, Michael Steffens, Maike Below, Matthias Schmid, Bettina Wedi, Dorothea Wieczorek, Philipp M. Amann, Harald Löffler, Lukas Koch, Clemens Schöffl, Heinrich Dickel, Nomun Ganjuur, Thorsten Hornung, Timo Buhl, Emel Aygören‐Pürsün, Gerda Wurpts, Jens Greve, Markus M. Nöthen, Andreas J. Forstner, Bernhardt Sachs
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Clinical and Translational Allergy
Subjects:
Online Access:https://doi.org/10.1002/clt2.70058
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849719724225593344
author Diana Dubrall
Nora L. Branding
Carina M. Mathey
Anna M. Weber
Michael Steffens
Maike Below
Matthias Schmid
Bettina Wedi
Dorothea Wieczorek
Philipp M. Amann
Harald Löffler
Lukas Koch
Clemens Schöffl
Heinrich Dickel
Nomun Ganjuur
Thorsten Hornung
Timo Buhl
Emel Aygören‐Pürsün
Gerda Wurpts
Jens Greve
Markus M. Nöthen
Andreas J. Forstner
Bernhardt Sachs
author_facet Diana Dubrall
Nora L. Branding
Carina M. Mathey
Anna M. Weber
Michael Steffens
Maike Below
Matthias Schmid
Bettina Wedi
Dorothea Wieczorek
Philipp M. Amann
Harald Löffler
Lukas Koch
Clemens Schöffl
Heinrich Dickel
Nomun Ganjuur
Thorsten Hornung
Timo Buhl
Emel Aygören‐Pürsün
Gerda Wurpts
Jens Greve
Markus M. Nöthen
Andreas J. Forstner
Bernhardt Sachs
author_sort Diana Dubrall
collection DOAJ
description Abstract Background Angioedema (AE) rarely occurs as a potentially life‐threatening adverse drug reaction (ADR) to angiotensin‐converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). The aim of the present study was to investigate non‐genetic association factors with ACEi‐/ARB‐induced angioedema in the European ADR database EudraVigilance and the database of the vARIANCE study. Methods The cohort of the vARIANCE study comprised 114 patients who suffered from ACEi‐ or ARB‐induced angioedema. In addition, 171 angioedema reports and 4650 reports on other ADRs of ACEi/ARB were identified in the ADR database EudraVigilance with the latter serving as a reference group. Odds ratios were calculated and a logistic regression analysis was performed using angioedema versus reference reports. Results Increased age, smoking, allergies and a history of previous angioedema were identified as associated factors for ACEi‐/ARB‐induced angioedema. In most patients, the swelling affected the face, lips and tongue. In the vARIANCE study, about 70% of angioedema occurred after 1 year of treatment. For one in two patients in the vARIANCE study (84.2% with ACEi treatment) and one in three patients from the EudraVigilance reports (59.6% with ARB treatment), the angioedema resulted in hospitalization. Conclusions We found small to moderate associations with certain individual patient‐related factors in this pharmaco‐epidemiological study. As a future perspective, combining non‐genetic association factors with corresponding genetic data might provide an option to compose stronger and individual risk scores.
format Article
id doaj-art-fb0dea07a33140e28552eb541f5aab01
institution DOAJ
issn 2045-7022
language English
publishDate 2025-05-01
publisher Wiley
record_format Article
series Clinical and Translational Allergy
spelling doaj-art-fb0dea07a33140e28552eb541f5aab012025-08-20T03:12:05ZengWileyClinical and Translational Allergy2045-70222025-05-01155n/an/a10.1002/clt2.70058Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedemaDiana Dubrall0Nora L. Branding1Carina M. Mathey2Anna M. Weber3Michael Steffens4Maike Below5Matthias Schmid6Bettina Wedi7Dorothea Wieczorek8Philipp M. Amann9Harald Löffler10Lukas Koch11Clemens Schöffl12Heinrich Dickel13Nomun Ganjuur14Thorsten Hornung15Timo Buhl16Emel Aygören‐Pürsün17Gerda Wurpts18Jens Greve19Markus M. Nöthen20Andreas J. Forstner21Bernhardt Sachs22Institute for Medical Biometry Informatics and Epidemiology University Hospital of Bonn Bonn GermanyResearch Division Federal Institute of Drugs and Medical Devices (BfArM) Bonn GermanyResearch Division Federal Institute of Drugs and Medical Devices (BfArM) Bonn GermanyResearch Division Federal Institute of Drugs and Medical Devices (BfArM) Bonn GermanyResearch Division Federal Institute of Drugs and Medical Devices (BfArM) Bonn GermanyCentral Research Institute for Ambulatory Health Care in Germany Berlin GermanyInstitute for Medical Biometry Informatics and Epidemiology University Hospital of Bonn Bonn GermanyKlinik für Dermatologie Allergologie und Venerologie Medizinische Hochschule Hannover Hannover GermanyKlinik für Dermatologie Allergologie und Venerologie Medizinische Hochschule Hannover Hannover GermanyKlinik für Dermatologie Allergologie und Phlebologie SLK‐Kliniken Heilbronn Heilbronn GermanyKlinik für Dermatologie Allergologie und Phlebologie SLK‐Kliniken Heilbronn Heilbronn GermanyDepartment of Dermatology and Venereology Medical University of Graz Graz AustriaDepartment of Dermatology and Venereology Medical University of Graz Graz AustriaDepartment of Dermatology, Venereology and Allergology St. Josef Hospital University Medical Center Ruhr University Bochum Bochum GermanyDepartment of Dermatology, Venereology and Allergology St. Josef Hospital University Medical Center Ruhr University Bochum Bochum GermanyZentrum für Hauterkrankungen Universitätsklinikum Bonn Bonn GermanyKlinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen Göttingen GermanyDepartment of Pediatrics Goethe University Frankfurt Frankfurt GermanyKlinik für Dermatologie und Allergologie ‐ Hautklinik Universitätsklinik der RWTH Aachen Aachen GermanyDepartment of Otorhinolaryngology—Head and Neck Surgery Ulm University Medical Center Ulm GermanyInstitute of Human Genetics University of Bonn School of Medicine and University Hospital Bonn Bonn GermanyInstitute of Human Genetics University of Bonn School of Medicine and University Hospital Bonn Bonn GermanyResearch Division Federal Institute of Drugs and Medical Devices (BfArM) Bonn GermanyAbstract Background Angioedema (AE) rarely occurs as a potentially life‐threatening adverse drug reaction (ADR) to angiotensin‐converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). The aim of the present study was to investigate non‐genetic association factors with ACEi‐/ARB‐induced angioedema in the European ADR database EudraVigilance and the database of the vARIANCE study. Methods The cohort of the vARIANCE study comprised 114 patients who suffered from ACEi‐ or ARB‐induced angioedema. In addition, 171 angioedema reports and 4650 reports on other ADRs of ACEi/ARB were identified in the ADR database EudraVigilance with the latter serving as a reference group. Odds ratios were calculated and a logistic regression analysis was performed using angioedema versus reference reports. Results Increased age, smoking, allergies and a history of previous angioedema were identified as associated factors for ACEi‐/ARB‐induced angioedema. In most patients, the swelling affected the face, lips and tongue. In the vARIANCE study, about 70% of angioedema occurred after 1 year of treatment. For one in two patients in the vARIANCE study (84.2% with ACEi treatment) and one in three patients from the EudraVigilance reports (59.6% with ARB treatment), the angioedema resulted in hospitalization. Conclusions We found small to moderate associations with certain individual patient‐related factors in this pharmaco‐epidemiological study. As a future perspective, combining non‐genetic association factors with corresponding genetic data might provide an option to compose stronger and individual risk scores.https://doi.org/10.1002/clt2.70058angioedemaangiotensin‐converting enzyme inhibitorsangiotensin‐receptor blockersdrug‐induced angioedemaspontaneous reports
spellingShingle Diana Dubrall
Nora L. Branding
Carina M. Mathey
Anna M. Weber
Michael Steffens
Maike Below
Matthias Schmid
Bettina Wedi
Dorothea Wieczorek
Philipp M. Amann
Harald Löffler
Lukas Koch
Clemens Schöffl
Heinrich Dickel
Nomun Ganjuur
Thorsten Hornung
Timo Buhl
Emel Aygören‐Pürsün
Gerda Wurpts
Jens Greve
Markus M. Nöthen
Andreas J. Forstner
Bernhardt Sachs
Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
Clinical and Translational Allergy
angioedema
angiotensin‐converting enzyme inhibitors
angiotensin‐receptor blockers
drug‐induced angioedema
spontaneous reports
title Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
title_full Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
title_fullStr Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
title_full_unstemmed Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
title_short Non‐genetic factors associated with ACE‐inhibitor and angiotensin receptor blocker‐induced angioedema
title_sort non genetic factors associated with ace inhibitor and angiotensin receptor blocker induced angioedema
topic angioedema
angiotensin‐converting enzyme inhibitors
angiotensin‐receptor blockers
drug‐induced angioedema
spontaneous reports
url https://doi.org/10.1002/clt2.70058
work_keys_str_mv AT dianadubrall nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT noralbranding nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT carinammathey nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT annamweber nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT michaelsteffens nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT maikebelow nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT matthiasschmid nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT bettinawedi nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT dorotheawieczorek nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT philippmamann nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT haraldloffler nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT lukaskoch nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT clemensschoffl nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT heinrichdickel nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT nomunganjuur nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT thorstenhornung nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT timobuhl nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT emelaygorenpursun nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT gerdawurpts nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT jensgreve nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT markusmnothen nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT andreasjforstner nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema
AT bernhardtsachs nongeneticfactorsassociatedwithaceinhibitorandangiotensinreceptorblockerinducedangioedema