Drug updated on 3/28/2024
| Dosage Form | Injection (intravenous; 2.5 mg/mL) |
| Drug Class | Vasoconstrictors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated to increase blood pressure in adults with septic or other distributive shock.
Summary
- Angiotensin II (Giapreza) is indicated to increase blood pressure in adults with septic or other distributive shock.
- Three systematic reviews/meta-analyses were reviewed for this summary, providing insights into the use and effectiveness of Giapreza in treating vasodilatory shock.
- The first review found that angiotensin II can effectively increase mean arterial pressure (MAP) and overall blood pressure in patients suffering from vasodilatory shock, potentially reducing mortality rates especially when administered to patients with elevated renin levels.
- According to the second study, angiotensin II has been shown effective at elevating blood pressure while also reducing the dose of concurrent vasopressors needed to maintain adequate blood pressure; however, its clinical benefits compared with traditional vasopressors are yet to be established conclusively.
- In terms of safety concerns raised across these studies: thromboembolism was associated with angiotensin II usage according to one study; another highlighted potential ischemia risks linked with terlipressin/selepressin but did not mention such risk for Giapreza specifically.
- Overall, despite some promising results regarding efficacy and tolerability of Angiotensin II (Giapreza), more research is required particularly on its cost-effectiveness compared against currently available alternatives before it could be recommended as a standard treatment option for septic or other distributive shocks beyond salvage therapy scenarios where conventional treatments have failed.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Giapreza (angiotensin II) Prescribing Information. | 2021 | La Jolla Pharmaceutical Company, San Diego, CA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| How effective is angiotensin ii in decreasing mortality of vasodilatory shock? a systematic review. | 2022 | Open Access Emergency Medicine |
| Assessment report: Giapreza. | 2019 | EMA |
| Angiotensin II: a new vasopressor for the treatment of distributive shock. | 2019 | Clinical Therapeutics |
| Novel vasopressors in the treatment of vasodilatory shock: a systematic review of angiotensin II, selepressin, and terlipressin. | 2018 | Journal of Intensive Care Medicine |