Trial reportPLoS neglected tropical diseases2010
Randomised controlled double-blind non-inferiority trial of two antivenoms for saw-scaled or carpet viper (Echis ocellatus) envenoming in Nigeria.
Trial report in PLoS neglected tropical diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 5 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Outcomes in intervention research on snakebite envenomation: a systematic review.F1000Research · 2022Pooled it
- Clinical outcomes and outcome measurement tools reported in randomised controlled trials of treatment for snakebite envenoming: A systematic review.PLoS neglected tropical diseases · 2021Pooled it
- The 20-minute whole blood clotting test (20WBCT) for snakebite coagulopathy-A systematic review and meta-analysis of diagnostic test accuracy.PLoS neglected tropical diseases · 2021Pooled it
- Reviewing evidence of the clinical effectiveness of commercially available antivenoms in sub-Saharan Africa identifies the need for a multi-centre, multi-antivenom clinical trial.PLoS neglected tropical diseases · 2019Pooled it
- Snake antivenom for snake venom induced consumption coagulopathy.The Cochrane database of systematic reviews · 2015Pooled it
- [Evaluation of the Efficacy and Tolerance of Tranexamic Acid Combined with InoserpMedecine tropicale et sante internationale · 2026Trial
- A Randomized Controlled Trial to Optimize Antivenom Therapy for Carpet Viper (Echis romani)-Envenomed Children in Nigeria.The American journal of tropical medicine and hygiene · 2024Trial
- Differential Hematotoxic Activity of Southeast Asian Pit Viper Venoms: The Cross-Neutralizing Effect of Available Antivenoms.Medical sciences (Basel, Switzerland) · 2026Article
- From scarcity to sustainability: Policy pathways for equitable snakebite antivenom access in Africa.PLOS global public health · 2026Review
- Predictors of In-Hospital Mortality Among Paediatric Snakebite Patients in Northeastern Nigeria: A Survival Analysis Study.Wellcome open research · 2026Article
- Preclinical evaluation of the neutralising efficacy of three antivenoms against the venoms of the recently taxonomically partitioned E. ocellatus and E. romani.PLoS neglected tropical diseases · 2025Article
- Healthcare workers' priorities of WHO snakebite strategic objectives for the control and prevention of snakebite envenoming in Ghana: A machine learning statistical design of experiment modeling.PLoS neglected tropical diseases · 2025Article
- Symptoms and Management of Painful Progressive Swelling in Eswatini Snakebite Patients: A Prospective Observational Study.The American journal of tropical medicine and hygiene · 2025Observational
- Handheld Point-of-Care Devices for Snakebite Coagulopathy: A Scoping Review.Thrombosis and haemostasis · 2025Article
- Article
- Pharmacokinetics of Snake Antivenom Following Intravenous and Intramuscular Administration in Envenomed Large Animal Model.Pharmaceutics · 2025Article
- The SnaFab versus the Razi antivenom for treatment of snakebite envenomation: A randomized, double-blind (investigator and victims), active controlled, non-inferiority clinical trial.PLOS global public health · 2025Article
- [Abdominal bleeding caused by pit viper bite: a case report and literature review].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2024Review
- A polygeneric immunogen composed of 22 venoms from sub-Saharan African snakes to expand the neutralization scope of the EchiTAb-plus-ICP antivenom.Toxicon: X · 2024Article
- Synthetic development of a broadly neutralizing antibody against snake venom long-chain α-neurotoxins.Science translational medicine · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn West Africa, envenoming by saw-scaled or carpet vipers (Echis ocellatus) causes great morbidity and mortality, but there is a crisis in supply of effective and affordable antivenom (ISRCTN01257358).
methodsIn a randomised, double-blind, controlled, non-inferiority trial, "EchiTAb Plus-ICP" (ET-Plus) equine antivenom made by Instituto Clodomiro Picado was compared to "EchiTAb G" (ET-G) ovine antivenom made by MicroPharm, which is the standard of care in Nigeria and was developed from the original EchiTAb-Fab introduced in 1998. Both are caprylic acid purified whole IgG antivenoms. ET-G is monospecific for Echis ocellatus antivenom (initial dose 1 vial) and ET-Plus is polyspecific for E. ocellatus, Naja nigricollis and Bitis arietans (initial dose 3 vials). Both had been screened by pre-clinical and preliminary clinical dose-finding and safety studies. Patients who presented with incoagulable blood, indicative of systemic envenoming by E. ocellatus, were recruited in Kaltungo, north-eastern Nigeria. Those eligible and consenting were randomly allocated with equal probability to receive ET-Plus or ET-G. The primary outcome was permanent restoration of blood coagulability 6 hours after the start of treatment, assessed by a simple whole blood clotting test repeated 6, 12, 18, 24 and 48 hr after treatment. Secondary (safety) outcomes were the incidences of anaphylactic, pyrogenic and late serum sickness-type antivenom reactions.
findingsInitial doses permanently restored blood coagulability at 6 hours in 161/194 (83.0%) of ET-Plus and 156/206 (75.7%) of ET-G treated patients (Relative Risk [RR] 1.10 one-sided 95% CI lower limit 1.01; P = 0.05). ET-Plus caused early reactions on more occasions than did ET-G [50/194 (25.8%) and 39/206 (18.9%) respectively RR (1.36 one-sided 95% CI 1.86 upper limit; P = 0.06). These reactions were classified as severe in 21 (10.8%) and 11 (5.3%) of patients, respectively.
conclusionAt these doses, ET-Plus was slightly more effective but ET-G was slightly safer. Both are recommended for treating E. ocellatus envenoming in Nigeria.
trial registrationCurrent Controlled Trials ISRCTN01257358.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.