In the French armed forces, the emergency treatment against nerve agent poisoning is the oxime pralidoxime methylsulfate (Contrathion®), included in a bicompartment autoinjector (AIBC, Ineurope ®), combined with atropine sulphate and avizafone chlorhydrate. However, the reactivating potency of pralidoxime methylsulfate is weak against specific nerve agents such as Russian VX (VR). To assess whether the oxime HI-6 dimethylsulfonate (HI-6-DMS) could replace pralidoxime methylsulfate, we tested the efficacy of the combined treatment including HI-6-DMS against increasing doses of VR. Given the strong inter-species variability in the efficacy of oximes, the French regulatory agency (Agence nationale de sécurité du medicament) requested data obtained in non-human primates. The cynomolgus monkey strain was selected since background data from previous studies were available. A better efficacy of HI-6-DMS AIBC was clearly evidenced: up to 5 LD 50 of VR, HI-6-DMS combined with atropine and avizafone, administered shortly after the onset of clinical signs allowed a better survival and recovery of intoxicated animals.
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