Following North American pit viper envenomation, what is the rate of delayed coagulopathy following treatment with Crotalidae immune F(ab’)2 versus Crotalidae polyvalent immune Fab?
In a double-blind randomized clinical trial, the rate of delayed coagulopathy in patients treated with Crotalidae immune F(ab’)2 versus Crotalidae polyvalent immune Fab were 10.3% and 29.7% respectively, on day 8 post envenomation. Crotalidae immune F(ab’)2 compared to Crotalidae polyvalent immune Fab uses pepsin digestion which keeps Fab fragments joined to form a larger antibody therefore leading to prolonged duration of action comparable to clinical effects of toxin.
Bush SP, et al. Comparison of F(ab′)2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial. Clin Toxicol (Phila). 2015;53:37–45.
Contributed by: Oyeyimika Oyekanmi, DO