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Clinical Trial of an F(ab’)₂ Polyvalent Equine Antivenom for African Snake Bites in Benin

J.-P. Chippaux^*, A. Massougbodji, R. P. Stock, A. Alagon the Investigators of African Antivipmyn® in Benin

We report the results of a trial designed to measure the safety and efficacy of African Antivipmyn^®, a new freeze-dried polyvalent equine F(ab’)₂-based antivenom. We tested 289 envenomations. After treatment, 19% of treated patients had undesirable events, all benign. A possible adverse effect was attributed to this antivenom in 11% of the patients. Bleeding was observed in 48% of the patients; it stopped within 2 hours after treatment with antivenom in 60% of the patients. Blood incoagulability was observed in 80% of the patients. Restoration of coagulation was attained within 4 hours in 60% of the patients. Nine patients died; 6 arrived at the hospital in the final stage of complications and 5 arrived at the hospital more than 60 hours after the bite. The value of blood coagulation tests in diagnosis of envenomation and bleeding as an indicator of renewal of treatment are emphasized.

Received February 21, 2007. Accepted for publication May 16, 2007.

Acknowledgments: We thank Juan López de Silanes and Jorge Paniagua-Solís (Laboratorios Silanes, Mexico City, Mexico) for donating the doses of African Antivipmyn used in this study, Blanca Ramos-Cerrillo for contributing to the development of the E. ocellatus capture essay, Judith Estévez and Adolfo de Roodt for participation in antivenom development, Walter García for logistical support and valuable comments during the study, and the nurses and laboratory technicians of all centers for their valuable help during the work.

Financial support: This study was supported by a grant from Instituto Bioclon/Laboratorios Silanes (Mexico) for a collaborative study between the Institut de Recherche pour le Développement (France), the Instituto de Biotecnología - Universidad Nacional Autonónoma de México (Mexico), and the Faculté des Sciences de la Santé (Benin).

^* Address correspondence to J.-P. Chippaux, Unité de Recherche 010, Institut de Recherche pour le Développement, C.P. 9214 La Paz, Bolivia. E-mail: chippaux{at}ird.fr

Investigators of African Antivipmyn^® in Benin: E. Fassinou, A. Ndamadjo (Kandi); R. Soglo (Gogounou); B. E. Tamou (Bembéréké); A. B. Mama, A. Nguemezi (Nikki); A. Salako, J.-P. Hounyet, A. Koussémou (Boko); Y. A. Mongbo (Tchaourou); A. Santos, A. Batonon (Papané); L. Loukmann M. Tévoèdjrè (Ouéssé); A. Yaya (Savé); Y. Agbangla, S. Ahoui (Glazoué); C. Agossadou (Dassa).

Authors’ addresses: J.-P. Chippaux, Unité de Recherche 010, Institut de Recherche pour le Développement, La Paz, Bolivia. A. Massougbodji, Faculté des Sciences de la Santé de Cotonou, Cotonou, Benin. R. P. Stock and A. Alagon, Instituto de Biotecnología, Universidad Nacional Autonónoma de México, Cuernavaca, Morelos, Mexico.