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https://www.readbyqxmd.com/read/29746978/clinical-studies-of-the-effectiveness-and-safety-of-antivenoms
#1
David J Williams, Abdulrazaq G Habib, David A Warrell
In the 1890s, hyperimmune sera proved effective in animals against challenge by the snake venom against which they had been raised. They were first used, apparently successfully, in a human patient in about 1895. Since then, antivenoms have become accepted as the only reliable specific treatment for snake-bite envenoming. Despite decades of accumulated clinical experience and a number of published randomised comparative and observational studies, the clinical effectiveness and safety of some antivenoms remain open to question, due to a lack of robust randomised controlled trial data...
May 7, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29534892/pros-and-cons-of-different-therapeutic-antibody-formats-for-recombinant-antivenom-development
#2
Andreas H Laustsen, José María Gutiérrez, Cecilie Knudsen, Kristoffer H Johansen, Erick Bermúdez-Méndez, Felipe A Cerni, Jonas A Jürgensen, Line Ledsgaard, Andrea Martos-Esteban, Mia Øhlenschlæger, Urska Pus, Mikael R Andersen, Bruno Lomonte, Mikael Engmark, Manuela B Pucca
Antibody technologies are being increasingly applied in the field of toxinology. Fuelled by the many advances in immunology, synthetic biology, and antibody research, different approaches and antibody formats are being investigated for the ability to neutralize animal toxins. These different molecular formats each have their own therapeutic characteristics. In this review, we provide an overview of the advances made in the development of toxin-targeting antibodies, and discuss the benefits and drawbacks of different antibody formats in relation to their ability to neutralize toxins, pharmacokinetic features, propensity to cause adverse reactions, formulation, and expression for research and development (R&D) purposes and large-scale manufacturing...
May 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29507580/antivenom-therapy-efficacy-of-premedication-for-the-prevention-of-adverse-reactions
#3
REVIEW
Victor Morais
Antivenoms or antitoxins have been effectively used for more than a century. During this time, these products have always proven to be highly effective in the treatment of infections and envenomations. However, antivenoms did not exhibit good safety results in their initial applications. After many improvements, antivenoms have substantially better safety profiles but still have some side effects. Due to the occurrence of adverse reactions, the practice of using premedication with the intent to decrease side effects has become accepted or mandatory in many countries...
2018: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/29326487/antitoxin-activity-of-aqueous-extract-of-cyclea-peltata-root-against-naja-naja-venom
#4
Thulasi Sivaraman, N S Sreedevi, S Meenatchisundaram, R Vadivelan
OBJECTIVES: Snakebites are a significant and severe global health problem. Till date, anti-snake venom serum is the only beneficial remedy existing on treating the snakebite victims. As antivenom was reported to induce early or late adverse reactions to human beings, snake venom neutralizing potential for Cyclea peltata root extract was tested for the present research by ex vivo and in vivo approaches on Naja naja toxin. MATERIALS AND METHODS: Ex vivo evaluation of venom toxicity and neutralization assays was carried out...
July 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29176824/safety-and-efficacy-of-a-freeze-dried-trivalent-antivenom-for-snakebites-in-the-brazilian-amazon-an-open-randomized-controlled-phase-iib-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Iran Mendonça-da-Silva, Antônio Magela Tavares, Jacqueline Sachett, José Felipe Sardinha, Lilian Zaparolli, Maria Fátima Gomes Santos, Marcus Lacerda, Wuelton Marcelo Monteiro
BACKGROUND: In tropical areas, a major concern regarding snakebites treatment effectiveness relates to the failure in liquid antivenom (AV) distribution due to the lack of an adequate cold chain in remote areas. To minimize this problem, freeze-drying has been suggested to improve AV stability. METHODS AND FINDINGS: This study compares the safety and efficacy of a freeze-dried trivalent antivenom (FDTAV) and the standard liquid AV provided by the Brazilian Ministry of Health (SLAV) to treat Bothrops, Lachesis and Crotalus snakebites...
November 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28764620/the-australian-snakebite-project-2005-2015-asp-20
#6
MULTICENTER STUDY
Christopher I Johnston, Nicole M Ryan, Colin B Page, Nicholas A Buckley, Simon Ga Brown, Margaret A O'Leary, Geoffrey K Isbister
OBJECTIVE: To describe the epidemiology, treatment and adverse events after snakebite in Australia. DESIGN: Prospective, multicentre study of data on patients with snakebites recruited to the Australian Snakebite Project (2005-2015) and data from the National Coronial Information System. Setting, participants: Patients presenting to Australian hospitals with suspected or confirmed snakebites from July 2005 to June 2015 and consenting to participation. MAIN OUTCOME MEASURES: Demographic data, circumstances of bites, clinical effects of envenoming, results of laboratory investigations and snake venom detection kit (SVDK) testing, antivenom treatment and adverse reactions, time to discharge, deaths...
August 7, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28510574/dose-of-antivenom-for-the-treatment-of-snakebite-with-neurotoxic-envenoming-evidence-from-a-randomised-controlled-trial-in-nepal
#7
RANDOMIZED CONTROLLED TRIAL
Emilie Alirol, Sanjib Kumar Sharma, Anup Ghimire, Antoine Poncet, Christophe Combescure, Chabilal Thapa, Vijaya Prasad Paudel, Kalidas Adhikary, Walter Robert Taylor, David Warrell, Ulrich Kuch, François Chappuis
BACKGROUND: Currently, there is inadequate evidence on which to base clinical management of neurotoxic snakebite envenoming, especially in the choice of initial antivenom dosage. This randomised controlled trial compared the effectiveness and safety of high versus low initial antivenom dosage in victims of neurotoxic envenoming. METHODOLOGY/ PRINCIPAL FINDINGS: This was a balanced, randomised, double-blind trial that was conducted in three health care centers located in the Terai plains of Nepal...
May 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28419970/effect-of-premedication-with-subcutaneous-adrenaline-on-the-pharmacokinetics-and-immunogenicity-of-equine-whole-igg-antivenom-in-a-rabbit-model
#8
María Herrera, Melvin Sánchez, Anderson Machado, Nils Ramírez, Mariángela Vargas, Mauren Villalta, Andrés Sánchez, Álvaro Segura, Aarón Gómez, Gabriela Solano, José María Gutiérrez, Guillermo León
Subcutaneous administration of a low dose of adrenaline is used to prevent the early adverse reactions (EARs) induced by snake antivenoms. We used a rabbit model to study the effect of premedication with adrenaline on the potential of antivenoms to exert therapeutic effects and to induce late adverse reactions. We found that premedication with adrenaline did not change the heart rate or blood pressure of normal rabbits, but reduced the rise in temperature in rabbits previously sensitized with antivenom. Pharmacokinetic studies suggest that premedication with adrenaline does not affect the ability of the antivenom to exert the initial control of envenomation nor the susceptibility of rabbits to develop recurrence of antigenemia and envenomation...
June 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28349771/antivenom-for-european-vipera-species-envenoming
#9
REVIEW
Thomas Lamb, Luc de Haro, Davide Lonati, Miran Brvar, Michael Eddleston
BACKGROUND: European viper bite is relatively uncommon but can cause serious envenoming, particularly swelling and hemorrhage spreading from limb to trunk that can cause long term disability. Systemic features are relatively mild compared to many other venomous species. Moderate-to-severe envenoming requires antivenom, which is given many hundreds of times each year across the continent. Several Vipera spp antivenoms are produced in Europe, but there is little comparative information available for the antivenoms and none is licensed with the European Medicines Agency...
July 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28138054/bites-by-the-monocled-cobra-naja-kaouthia-in-chittagong-division-bangladesh-epidemiology-clinical-features-of-envenoming-and-management-of-70-identified-cases
#10
M A Faiz, M F Ahsan, A Ghose, M R Rahman, R Amin, M Hossain, M N U Tareq, M A Jalil, U Kuch, R D G Theakston, D A Warrell, J B Harris
AbstractWe describe 70 cases of monocled cobra ( Naja kaouthia ) bite admitted to Chittagong Medical College Hospital, Bangladesh. The biting snakes were identified by examining the dead snake and/or detecting N. kaouthia venom antigens in patients' serum. Bites were most common in the early morning and evening during the monsoon (May-July). Ligatures were routinely applied to the bitten limb before admission. Thirty-seven patients consulted traditional healers, most of whom made incisions around the bite site...
April 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28103732/evaluation-of-antivenom-therapy-for-vipera-palaestinae-bites-in-children-experience-of-two-large-tertiary-care-pediatric-hospitals
#11
Dikla Pivko-Levy, Itamar Munchnak, Ayelet Rimon, Uri Balla, Dennis Scolnik, Christopher Hoyte, Yair Voliovitch, Miguel Glatstein
BACKGROUND: Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children...
April 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/27762105/clinical-profile-and-laboratory-parameters-in-1051-victims-of-snakebite-from-a-single-centre-in-kerala-south-india
#12
J C Menon, J K Joseph, M P Jose, B L Dhananjaya, O V Oommen
INTRODUCTION: Snakebite is an occupational hazard causing considerable morbidity and mortality worldwide, particularly so in tropical countries like India. OBJECTIVE: The aim of this study is to (i) review the demographic, clinical and laboratory findings in patients (1051) admitted with venomous snakebite (ii) to correlate mortality, morbidity and duration of hospital stay with clinical signs, symptoms and laboratory parameters. METHODS: A retrospective study of 1051 patients treated for snakebite over 10 years (2000 - 2009) in Little Flower Hospital, Angamaly, Kerala...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27530663/efficacy-of-intravenous-hydrocortisone-administered-2-4%C3%A2-h-prior-to-antivenom-as-prophylaxis-against-adverse-drug-reactions-to-snake-antivenom-in-sri-lanka-an-open-labelled-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Senanayake A M Kularatne, Kosala Weerakoon, Anjana Silva, Kalana Maduwage, Chamara Walathara, Ishani Rathnayake, Senal Medagedara, Ranjith Paranagama, Suresh Mendis, P V R Kumarasiri
The prevention of adverse drug reactions to antivenom serum poses a formidable challenge in the management of snakebite. Hydrocortisone is being used concurrently with antivenom in order to prevent these adverse drug reactions without a proven benefit. However, all previous studies seemed to ignore the testing of effectiveness of hydrocortisone therapy during its pharmacological effects, which come hours later. On this principle, we aimed to test the effectiveness of intravenous hydrocortisone given 2 h or more prior to the commencement of antivenom therapy to reduce adverse drug reactions to antivenom...
September 15, 2016: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/27027633/cost-effectiveness-of-antivenoms-for-snakebite-envenoming-in-16-countries-in-west-africa
#14
Muhammad Hamza, Maryam A Idris, Musa B Maiyaki, Mohammed Lamorde, Jean-Philippe Chippaux, David A Warrell, Andreas Kuznik, Abdulrazaq G Habib
BACKGROUND: Snakebite poisoning is a significant medical problem in agricultural societies in Sub Saharan Africa. Antivenom (AV) is the standard treatment, and we assessed the cost-effectiveness of making it available in 16 countries in West Africa. METHODS: We determined the cost-effectiveness of AV based on a decision-tree model from a public payer perspective. Specific AVs included in the model were Antivipmyn, FAV Afrique, EchiTab-G and EchiTab-Plus. We derived inputs from the literature which included: type of snakes causing bites (carpet viper (Echis species)/non-carpet viper), AV effectiveness against death, mortality without AV, probability of Early Adverse Reactions (EAR), likelihood of death from EAR, average age at envenomation in years, anticipated remaining life span and likelihood of amputation...
March 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/26995210/prospective-consecutive-case-series-of-158-snakebite-patients-treated-at-savannakhet-provincial-hospital-lao-people-s-democratic-republic-with-high-incidence-of-anaphylactic-shock-to-horse-derived-f-ab-2-antivenom
#15
Inthanomchanh Vongphoumy, Phankham Chanthilat, Phongmany Vilayvong, Joerg Blessmann
Snakebites are a seriously neglected public health problem in Lao PDR. Community-based cross-sectional surveys in two districts of Savannakhet province in Southern Laos revealed an incidence of up to 1105 snakebites per 100,000 persons per year. In contrast the number of snakebite patients treated in district and provincial hospitals are low. In order to improve health care for snakebite victims, antivenom was introduced to Savannakhet provincial hospital in July 2013 and medical staff has been trained in management of venomous snakebites at the same time...
July 2016: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/26309424/pattern-of-adverse-drug-reactions-in-children-attending-the-department-of-pediatrics-in-a-tertiary-care-center-a-prospective-observational-study
#16
Kishour Kumar Digra, Aakash Pandita, G S Saini, Rajni Bharti
AIM: To study the pattern of various adverse drug reactions (ADRs) occurring in children attending the Department of Pediatrics, SMGS Hospital, Jammu over 1 year. SUBJECTS AND METHODS: This was a prospective study, with study population of patients attending Department of Pediatrics over a period of 1 year. A structured format was used to enroll the participants. A pilot study was conducted to test the suitability of the format and feasibility of the study. The study was carried out to review various pattern of ADRs by using the Naranjo probability scale, and severity was assessed by using the Hartwig severity scale...
2015: Clinical Medicine Insights. Pediatrics
https://www.readbyqxmd.com/read/26256124/adverse-reactions-to-snake-antivenom-and-their-prevention-and-treatment
#17
REVIEW
H Asita de Silva, Nicole M Ryan, H Janaka de Silva
Antivenom is the mainstay of treatment of snakebite envenoming. However, adverse reactions to snake antivenom that is available are common in many parts of the world where snakebite is prevalent. Both acute (anaphylactic or pyrogenic) and delayed (serum sickness type) reactions occur. Acute reactions are usually mild but severe systemic anaphylaxis may develop, often within an hour or so of exposure to antivenom. Serum sickness after antivenom has a delayed onset between 5 and 14 days after its administration...
March 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/26242786/quality-control-testing-for-tracking-endotoxin-producing-gram-negative-bacteria-during-the-preparation-of-polyvalent-snake-antivenom-immunoglobulin
#18
Norhan S Sheraba, Mohamed R Diab, Aymen S Yassin, Magdy A Amin, Hamdallah H Zedan
UNLABELLED: Snake bites represent a serious public health problem, particularly in rural areas worldwide. Antitoxic sera preparations are antibodies from immunized animals and are considered to be the only treatment option. The purification of antivenom antibodies should aim at obtaining products of consistent quality, safety, efficacy, and adherence to good manufacturing practice principles. Endotoxins are an integral component of the outer cell surface of Gram-negative bacteria. They are common contaminates of the raw materials and processing equipment used in the manufacturing of antivenoms...
July 2015: PDA Journal of Pharmaceutical Science and Technology
https://www.readbyqxmd.com/read/25705418/clinical-characteristics-of-redback-spider-bites
#19
Toru Hifumi, Satoshi Fujimi, Takuya Yamagishi, Satoru Arai, Kyoko Sawabe, Akihiko Yamamoto, Manabu Ato, Keigo Shibayama, Akihiko Ginnaga, Nobuaki Kiriu, Hiroshi Kato, Yuichi Koido, Junichi Inoue, Masanobu Kishikawa, Yuko Abe, Kenya Kawakita, Masanobu Hagiike, Yasuhiro Kuroda
BACKGROUND: Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia. Since the first case report in 1997 (Osaka), RBS bites have been a clinical and administrative issue in Japan; however, the clinical characteristics and effective treatment of RBS bites, particularly outside Australia remains unclear. This study aimed to elucidate the clinical characteristics of RBS bites and to clarify the effectiveness of the administration of antivenom for treatment...
2014: Journal of Intensive Care
https://www.readbyqxmd.com/read/25569252/cost-effectiveness-of-antivenoms-for-snakebite-envenoming-in-nigeria
#20
Abdulrazaq G Habib, Mohammed Lamorde, Mahmood M Dalhat, Zaiyad G Habib, Andreas Kuznik
BACKGROUND: Snakebite envenoming is a major public health problem throughout the rural tropics. Antivenom is effective in reducing mortality and remains the mainstay of therapy. This study aimed to determine the cost-effectiveness of using effective antivenoms for Snakebite envenoming in Nigeria. METHODOLOGY: Economic analysis was conducted from a public healthcare system perspective. Estimates of model inputs were obtained from the literature. Incremental Cost Effectiveness Ratios (ICERs) were quantified as deaths and Disability-Adjusted-Life-Years (DALY) averted from antivenom therapy...
January 2015: PLoS Neglected Tropical Diseases
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