engleski

Comparison of preclinical properties of several available antivenoms in the search for effective treatment of Vipera ammodytes and Vipera berus envenoming

Snakebites in Europe are mostly caused by Vipera ammodytes, Vipera berus and Vipera aspis. Among eight available antivenoms, only Zagreb antivenom, Viperfav and ViperaTAb have been used almost exclusively for decades. Zagreb antivenom and Viperfav are considered clinically efficient against envenoming caused by all three medically relevant species, while ViperaTAb is indicated for the treatment of V. berus bites solely. When the production of Zagreb antivenom was discontinued and a shortage of Viperfav occurred, other potentially suitable antivenoms were implemented into clinical practice, but without comparative assessment of their eligibility. The aim of our work was to identify at preclinical level a high- quality antivenom that might ensure successful treatment of envenoming caused by both V. ammodytes and V. berus. A thorough preclinical analysis of the safety- related properties and efficacy of a panel of anti-Vipera spp. antivenoms that are currently available, or in development for the European market, was performed in a comparative manner. Emphasis was placed on their physicochemical properties, primarily purity and aggregate content, and in vivo protective efficacies. As Zagreb antivenom is no longer available on the European market, Viperfav emerged as the highest-quality product and the only one whose neutralisation potency against V. ammodytes and V. berus venoms was above regulatory requirements. Although monitoring of effectiveness is of utmost importance in the decision-making process, the presented findings may serve as a starting point for guidance to clinicians when choosing the most appropriate antivenom for the treatment of envenoming in Southeastern Europe.

Zagreb antivenom ; Viperfav ; ViperaTAb ; Vipera ammodytes ; Vipera berus ; preclinical efficacy

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