Obiltoxaximab: Adding to the Treatment Arsenal for Bacillus anthracis Infection

Abstract

Based on these clinical studies and the implausibility of conducting a trial in infected individuals, obiltoxaximab is a safe and efficacious addition to the anthrax antitoxin armamentarium to protect against and treat inhalational anthrax.

Using Omics Technologies and Systems Biology to Identify Epitope Targets for the Development of Monoclonal Antibodies Against Antibiotic-Resistant Bacteria

“…However, despite the fact that a large number of therapeutic mAbs have been successfully developed for multiple different human pathologies, most notably for rheumatologic and oncologic diseases, only three mAb therapies have been approved for bacterial infections. Raxibacumab and obiltoxaximab have been developed for inhalational anthrax (7,8), while bezlotoxumab was recently approved for the prevention of Clostridium difficile infection (9). The relative paucity of mAbs for bacterial infections is especially noteworthy given the key role played by antibodies in bacterial clearance during natural infection and vaccine-induced immunity.…”

Disaster Preparedness: Biological Threats and Treatment Options

“…The newest anthrax antitoxin agent is obiltoxaximab, a human immunoglobulin G1 monoclonal antibody with a similar mechanism of action as raxibacumab. It is given as a single IV dose (16 mg/kg if more than 40 kg) . Multiple animal treatment studies of rabbits and monkeys demonstrate significant improvement in survival with obiltoxaximab alone relative to placebo .…”

“…Although the additional benefit of antitoxin compared with antibiotic therapy alone is not completely clear, given the high mortality of disease and low potential toxicity of antitoxin, the benefits outweigh the risk of adjunctive antitoxin therapy . Anthrax immunoglobulin, raxibacumab, and obiltoxaximab are available via the CDC Strategic National Stockpile (SNS) …”

“…It is given as a single IV dose (16 mg/kg if more than 40 kg). 33,38 Multiple animal treatment studies of rabbits and monkeys demonstrate significant improvement in survival with obiltoxaximab alone relative to placebo. 39 In rabbits receiving 16 mg/kg, survival in two studies were 61.5% and 92.9%, which was significantly improved compared with no survivors in those given placebo (p = 0.0013 and p = 0.001, respectively).…”

“…26 Anthrax immunoglobulin, raxibacumab, and obiltoxaximab are available via the CDC Strategic National Stockpile (SNS). 38 Following exposure to B. anthracis spores, the two components for preventing disease with PEP are anthrax vaccine adsorbed (AVA) and antimicrobial agents. The Advisory Committee on Immunization Practices recommends the use of AVA for long-term postexposure protection in addition to immediate postexposure protection with 60 days of antimicrobial therapy.…”