Incidence of allergic reactions to Crotalidae polyvalent immune Fab

Khobrani, Moteb; Huckleberry, Yvonne; Boesen, Kevin; Aljabri, Ahmed; Alharthi, Mobarak; Patanwala, Asad E.

doi:10.1080/15563650.2018.1504956

Cited by 13 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Like in other studies, limited interventions beyond stopping the infusion and restarting at a slower rate along with antihistamines were necessary to address these reactions. [7][8][9][10][13][14][15] No patients in our analysis were known to have developed a delayed hypersensitivity, or serum sickness, reaction. This differs from the rates observed in previously published postmarketing studies examining F(ab')₂AV.…”

Section: Discussionmentioning

confidence: 95%

“…Although cases of rate-dependent hypersensitivity have not been specifically published for F(ab')₂AV, rate-dependent acute hypersensitivity reactions are a known feature of antibody-based therapies generally and are well described with FabAV. [13][14][15] A history of asthma was considered a risk factor for acute hypersensitivity reactions with prior crotalid antivenoms, although it is unknown whether this is the case for F(ab')₂AV. 16 The frequency of acute hypersensitivity reactions (7.7%) is similar to what has been described in prior literature and is likely magnified by our small sample size.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab’)₂ Antivenom

Seltzer,

Winkler,

Friedman

et al. 2023

Pediatr Emer Care

View full text Add to dashboard Cite

Objectives Rattlesnake envenomations are uncommon, and the majority occur in adults. Although Crotalidae equine immune F(ab’)₂ antivenom (F(ab’)₂AV; trade name ANAVIP) was introduced in 2018, no pediatric specific studies of F(ab’)₂AV have been reported to date. The objective of this study was to evaluate the clinical performance and adverse effects of F(ab’)₂AV in children. Methods A single-center, retrospective chart review was performed on patients with rattlesnake envenomation presenting to a children's hospital between October 2018 and August 2022. Inclusion criteria were age younger than 18 years and F(ab’)₂AV use. Exclusion criteria were other antivenom use at any time and presentation beyond 24 hours postenvenomation. Demographic characteristics, hemoglobin, platelet count, fibrinogen, international normalized ratio, number of F(ab’)₂AV vials used, infusion-related complications, and clinical outcomes were collected. Results Twenty-six patients, 19 males and 7 females, with a mean age of 7.7 years (0.67 to 16 years) met inclusion criteria. Fourteen (54%) were treated with only the initial 10 vial F(ab’)₂AV doses. Twelve patients were given additional doses with a median additional vials of 10 (4–34 vials; interquartile range, 8.75–12 vials). The median total vials given for all patients was 10 (10–44 vials; interquartile range, 10–20 vials). Two patients developed acute infusion reactions. Both were treated by slowing the infusion rate and with medications (diphenhydramine, corticosteroids). No delayed reactions were noted. No patients required blood products or surgical interventions. After discharge, no complications, recurrent symptoms, return visits, or readmissions were reported. Follow-up by chart review or phone was obtained for 18 patients, and no postdischarge complications were noted. Seven patients had postdischarge hematologic laboratory evaluations and all were normal. Conclusions Although limited by small sample size and postdischarge follow-up, F(ab’)₂AV was well tolerated in our series of pediatric patients, consistent with prior studies of all age groups.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Pediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab’)₂ Antivenom

Seltzer,

Winkler,

Friedman

et al. 2023

Pediatr Emer Care

View full text Add to dashboard Cite

show abstract

“…Our most important observation was the confirmation of a high rate of AEs related to antivenoms: almost half of the patients (22/47, 47%) presented with IRRs, a manifestation compatible with the type I hypersensitivity reaction. This early reaction is possibly mediated by previously formed IgE antibodies, whose binding with heterologous serum proteins promote the release of vasoactive mediators and the typical clinical manifestations of an allergic reaction (nasal and ocular congestion, nasal obstruction, wheezing, urticaria, angiedema, anaphylaxis or anaphylactic shock) 12 , 15 , 23 , 24 . A postulated alternative mechanism is also a variant form of the type I hypersensitivity reaction, the anaphylactoid reaction.…”

Section: Discussionmentioning

confidence: 99%

A phase IV, prospective, observational study of the clinical safety of snake antivenoms

Nogueira

Calil

Santos

et al. 2021

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

Snake envenoming is a neglected tropical disease that affects more than 2.7 million people worldwide. The treatment is based on the administration of antivenom composed of heterologous immunoglobulins, species-specific therapy involving the possibility of adverse reactions due to activation of the immune system. Considering the scarcity of prospective studies evaluating the safety of snake antivenoms, this study aimed to describe and characterize adverse events after antivenom infusion in an observational, prospective, single-centre investigation conducted in a referral centre in Brazil. A total of 47 victims of snake envenoming were included in the study, who were mostly men (75%), with ages ranging from 2 to 83 years. Twenty-two participants (47%) presented manifestations compatible with infusion-related reactions (IRRs) during or up to two hours after F(ab') 2 heterologous immunoglobulin infusion. The most common clinical manifestation related to the infusion was a diffuse cutaneous rash (82%), followed by respiratory manifestations (46%) and facial swelling (23%). In four cases (9%), IRR were considered serious adverse events (SAE), characterized by haemodynamic instability, airway obstruction or hypoxia. Only one patient developed symptoms compatible with serum sickness. Although almost half of the patients treated with antivenom sera experienced IRRs, the SAE rate was 9%; in all cases, the adverse reaction was reversible by using supportive treatment, and there were no deaths. The results have shown that there is much to improve in the antivenom production process to obtain a more purified and specific product. Even so, a timely antivenom serum administration managed by well-trained health teams is safe and prevents complications after snake-related accidents.

show abstract

“…This is likely because copperhead envenomation patients rarely develop life-threatening systemic effects, such as hypotension, neurotoxicity, severe defibrinogenation, or severe thrombocytopenia [8][9][10][11]. Although the previous, equine-derived antivenom had serious problems with acute hypersensitivity reactions and serum sickness that restricted its use to more serious envenomation cases, FabAV is generally safe and well-tolerated [12][13][14][15]. However, antivenoms are expensive.…”

Section: Introductionmentioning

confidence: 99%

Recovery from Copperhead Snake Envenomation: Role of Age, Sex, Bite Location, Severity, and Treatment

et al. 2019

View full text Add to dashboard Cite

Introduction Few data exist to understand the recovery phase of pit viper envenomation. A recently published placebo-controlled clinical trial affords this opportunity. The purpose of this study is to examine the time course of recovery from copperhead snake (Agkistrodon contortrix) envenomation patients managed with and without the use of antivenom, stratified by age, sex, anatomic site of envenomation, initial severity of envenomation, and geographic region. Methods This is a post-hoc subgroup analysis of data from a multi-center double-blinded clinical trial of Fab antivenom (FabAV) vs. placebo. Outcomes were the Patient-Specific Functional Scale (PSFS) score at 3, 7, 10, and 14 days after envenomation. Least-squares mean PSFS score curves were calculated for each subgroup, and repeated measures ANOVA was used to estimate between-group comparisons. Results Seventy-two subjects were included, of whom 44 received FabAV. Males demonstrated better overall recovery than females (model predicted PSFS score 6.18 vs 4.99; difference 1.19; 95% CI 0.12 to 2.25; p = 0.029). No sex difference was found in response to FabAV. Overall recovery and effect of FabAV were similar in adult vs adolescent patients, patients with This study has not been presented previously.

show abstract

Incidence of allergic reactions to Crotalidae polyvalent immune Fab

Cited by 13 publications

References 13 publications

Pediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab’)₂ Antivenom

Pediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab’)₂ Antivenom

A phase IV, prospective, observational study of the clinical safety of snake antivenoms

Recovery from Copperhead Snake Envenomation: Role of Age, Sex, Bite Location, Severity, and Treatment

Contact Info

Product

Resources

About