According to a recent systematic review, at what ethylene glycol concentration threshold is fomepizole monotherapy expected to fail?
As suggested by prior reports, the cited reference did not identify an ethylene glycol concentration over which fomepizole treatment is expected to fail. Adverse outcomes and treatment failures mostly occurred when severe metabolic acidemia and/or Stage 2–3 AKI was present. When these two conditions were absent on presentation, only rare, minor, and reversible complications occurred when fomepizole is used as monotherapy.
1. Jessie Beaulieu, Darren M. Roberts, Sophie Gosselin, Robert S. Hoffman, Valery Lavergne, Knut Erik Hovda, Bruno Megarbane, Derrick Lung, Ruben Thanacoody & Marc Ghannoum (2022) Treating ethylene glycol poisoning with alcohol dehydrogenase inhibition, but without extracorporeal treatments: a systematic review, Clinical Toxicology, 60:7, 784-797, DOI: 10.1080/15563650.2022.2049810