Efficacy and safety of two whole IgG polyvalent antivenoms, refined by caprylic acid fractionation with or without beta-propiolactone, in the treatment of Bothrops asper bites in Colombia

Otero, R., Leon, G., Gutierrez, J. M., Rojas, G., Toro, M. F., Barona, J., Rodriguez, V., Diaz, A., Nunez, V., Quintana, J. C., Ayala, S., Mosquera, D., Conrado, L. L., Fernandez, D., Arroyo, Y., Paniagua, C. A., Lopez, M., Ospina, C. E., Alzate, C., Fernandez, J., Meza, J. J., Silva, J. F., Ramirez, P., Fabra, P. E., Ramirez, E., Cordoba, E., Arrieta, A. B., Warrell, D. A. and Theakston, R.David G. (2006) 'Efficacy and safety of two whole IgG polyvalent antivenoms, refined by caprylic acid fractionation with or without beta-propiolactone, in the treatment of Bothrops asper bites in Colombia'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 100, Issue 12, pp. 1173-1182.

Full text not available from this repository.

Abstract

The efficacy and safety of two whole IgG polyvalent antivenoms (A and B) were compared in a randomised, blinded clinical trial in 67 patients systemically envenomed by Bothrops asper in Colombia. Both antivenoms were fractionated by caprylic acid precipitation and had similar neutralising potencies, protein concentrations and aggregate contents. Antivenom B was additionally treated with beta-propiolactone to tower its anticomplementary activity. Analysing all treatment regimens together, there were no significant differences between the two antivenoms (A = 34 patients; B = 33 patients) in the time taken to reverse venom-induced bleeding and coagulopathy, to restore physiological fibrinogen concentrations and to clear serum venom antigenaemia. Blood coagulability was restored within 6-24 h in 97% of patients, all of whom had normal coagulation and plasma fibrinogen Levels 48 h after the start of antivenom treatment. Two patients (3.0%) had recurrent coagulopathy and eight patients suffered recurrence of antigenaemia within 72 h of treatment. None of the dosage regimens of either antivenom used guaranteed resolution of venom-induced coagulopathy within 6 h, nor did they prevent recurrences. A further dose of antivenom at 6 h also did not guarantee resolution of coagulopathy within 12-24 h in all patients. The incidence of early adverse reactions (all mild) was similar for both antivenoms (15% and 24%; P > 0.05). (C) 2006 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Item Type:	Article
Uncontrolled Keywords:	bothrops asper envenomation serotherapy malayan pit viper calloselasma-rhodostoma immunoglobulin therapy commercial antivenoms comparative trial snake antivenoms clinical-trial anticomplementary activity recurrence phenomena intravenous use
Subjects:	QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 805 Vaccines. Antitoxins. Toxoids WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Animal Poisons > WD 410 Reptiles
Faculty: Department:	Groups (2002 - 2012) > Molecular & Biochemical Parasitology Group
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.trstmh.2006.01.006
Depositing User:	Ms Julia Martin
Date Deposited:	13 Jan 2011 16:19
Last Modified:	06 Feb 2018 13:02
URI:	https://archive.lstmed.ac.uk/id/eprint/1570

Statistics

View details

Actions (login required)

Edit Item