Adverse Events in the Efficacy of Crotalidae Polyvalent Immune Fab Antivenom vs Placebo in Recovery from Copperhead Snakebite Trial.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with Fab antivenom (FabAV) or placebo. METHODS: Patients with copperhead snakebites received treatment and follow-up in a prospective, randomized, double-blind, placebo-controlled trial of FabAV or placebo. The treatment allocation ratio was 2:1 (FabAV:placebo). All of the included patients received at least one dose of study treatment. We reviewed all treatment-emergent adverse events (AEs) using a previously published scale to classify likely hypersensitivity reactions as mild, moderate, or severe. RESULTS: We enrolled 74 patients at 13 sites. Forty-five patients received FabAV, and 29 patients received placebo. Five FabAV patients and 4 placebo patients had moderate envenomations; the rest were mild. Twenty-five FabAV patients and 8 placebo patients had at least 1 AE. Mild skin reactions occurred in 11 (24%) FabAV patients (pruritis, urticaria, rash, ecchymosis, erythema) and 1 (3%) placebo patient (pruritis). Moderate gastrointestinal AEs occurred in 7 (16%) FabAV patients (nausea, vomiting, constipation, diarrhea, oral paresthesia) and in 2 (7%) placebo patients (nausea). Respiratory AEs occurred in 3 (7%) FabAV patients (dyspnea, pulmonary embolism, nasal congestion, sneezing) and no placebo patients. Hypotension occurred in 1 patient in each group. CONCLUSIONS: In a randomized controlled trial of FabAV for copperhead bites, the incidence of hypersensitivity reactions was low. Most reactions were mild skin reactions.

Full Text

Duke Authors

Cited Authors

  • Mullins, ME; Gerardo, CJ; Bush, SP; Rose, SR; Greene, S; Quackenbush, EB; Lewis, B; Anderson, VE; Kleinschmidt, KC; Schwarz, RB; Charlton, NP; Toschlog, EA; Sharma, K; Denning, DA; Lavonas, EJ

Published Date

  • December 2018

Published In

Volume / Issue

  • 111 / 12

Start / End Page

  • 716 - 720

PubMed ID

  • 30512122

Electronic International Standard Serial Number (EISSN)

  • 1541-8243

Digital Object Identifier (DOI)

  • 10.14423/SMJ.0000000000000902


  • eng

Conference Location

  • United States