What is the typical duration of angioedema?

From the Guidelines

Angioedema typically lasts 24 to 72 hours without treatment, though the duration can vary depending on the cause and individual factors. The duration of angioedema is influenced by several factors, including the location and severity of swelling, as well as the underlying cause of the condition. According to a study published in the Journal of Allergy and Clinical Immunology 1, hereditary angioedema (HAE) attacks tend to progressively worsen for 24 hours and then slowly remit over the following 48 to 72 hours. However, attacks can occasionally last longer, particularly if the swelling moves from site to site.

Some key points to consider when evaluating the duration of angioedema include:

• The type of angioedema: HAE, allergic reactions, or ACE inhibitor-induced angioedema
• The location and severity of swelling: laryngeal angioedema requires immediate medical attention due to potential airway compromise
• The effectiveness of treatment: antihistamines, corticosteroids, C1 inhibitor concentrates, icatibant, or ecallantide
• The presence of underlying conditions: recurrent episodes warrant investigation to identify and address underlying causes

As noted in another study published in the same journal 1, HAE attacks are usually distinguished from allergic or idiopathic angioedema by their longer duration and lack of response to antihistamines, corticosteroids, or epinephrine. A third study 1 highlights the importance of on-demand treatment for acute attacks of HAE, which can be effective in reducing the duration and severity of symptoms. Treatment options should be tailored to the individual patient and the specific cause of their angioedema, with a focus on reducing morbidity, mortality, and improving quality of life.

From the FDA Drug Label

Table 10. Time to Initial Onset of Symptom Relief and Time to Complete Resolution of HAE Symptoms for Laryngeal HAE Attacks StatisticLaryngeal(n=48) Time to initial onset of symptom relief [hours] Median (range)0.25 (0.10 - 1.25) Time to complete resolution of HAE symptoms [hours] Median (range)8.4 (0.6 - 61.8*)

The typical duration of angioedema, specifically laryngeal HAE attacks, is as follows:

• Time to initial onset of symptom relief: 0.25 hours (median)
• Time to complete resolution of HAE symptoms: 8.4 hours (median) Note that the range for complete resolution of symptoms is wide, from 0.6 to 61.8 hours 2.

From the Research

Duration of Angioedema

The duration of angioedema can vary depending on the type and severity of the condition.

• Symptoms of hereditary angioedema typically last 48 to 72 hours, but can last anywhere from 4 hours to 1 week 3.
• Acute presentations of angioedema are typically transient and localized, but can result in acute airway compromise, requiring immediate stabilization 4.
• There is no specific information available on the exact duration of all types of angioedema, as it can vary greatly from person to person and depend on the underlying cause.

Factors Affecting Duration

Several factors can affect the duration of angioedema, including:

• The type of angioedema (allergic or non-allergic) 5
• The severity of the symptoms 3
• The effectiveness of treatment 6, 7
• The presence of any underlying medical conditions 4

Treatment and Duration

Treatment for angioedema can help alleviate symptoms and reduce the duration of the condition.

• Antihistamines, corticosteroids, and adrenalin can be used to treat allergic angioedema, but are ineffective in acute attacks of non-allergic angioedema 5.
• Bradykinin-B2-receptor antagonists, such as icatibant, and C1-INH concentrate can be used to treat non-allergic angioedema 5, 6.
• Fresh frozen plasma has been used to treat resistant angiotensin-converting enzyme inhibitor angioedema 7.