Evidence map›Paper›PMID 40817895›Full record

ArticleAnnals of emergency medicine2026

Prevalence of Adverse Drug Reactions: Comparing Crotalidae Immune Polyvalent Antivenoms F(ab')

Ari B Filip, Lina Mahmood, Collette Tilly, Howell R Foster, Fawn Jackson, William Banner, Thomas A E Platts-Mills, Jeffrey Wilson, Pamela Schoppee Bortz, Nathan Charlton and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Antivenom Choice in the Management of Snake Envenomation.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ari B FilipArkansas Poison and Drug Information Center, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR.
Lina MahmoodDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.
Collette TillyDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR; Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Howell R FosterArkansas Poison and Drug Information Center, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR.
Fawn JacksonArkansas Poison and Drug Information Center, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR.
William BannerOklahoma Center for Poison and Drug Information, College of Pharmacy, University of Oklahoma, Oklahoma City, OK.
Thomas A E Platts-MillsDivision of Allergy and Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA.
Jeffrey WilsonDivision of Allergy and Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA.
Pamela Schoppee BortzDivision of Allergy and Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA.
Nathan CharltonDepartment of Emergency Medicine, University of Virginia, Charlottesville, VA.
Joshua L KennedyDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR; Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR; Arkansas Children's Research Institute, Little Rock, AR. Electronic address: kennedyjoshual@uams.edu.

Funding

CTSA K12 Program at the University of Arkansas for Medical SciencesK12TR004924 · NCATS · UNIV OF ARKANSAS FOR MED SCIS · PI Jason Eli Farrar, Joshua Kennedy · 2024 to 2026
$2.3M
NCATS NIH HHS K12 TR004924NCIPC CDC HHS P30-CA044579
6 · The paper itself

Abstract

STUDY

objectivesNorth American pit viper antivenoms, CroFab® and ANAVIP®, contain galactose-α-1,3-galactose (α-GAL) oligosaccharide. We compared adverse drug reactions, including presumed anaphylaxis, following administration of these antivenoms and investigated biological plausibility of these antivenoms leading to anaphylaxis in α-GAL-immunoglobulin (Ig) E-sensitized individuals.

methodsWe performed 2 studies. A retrospective chart review from the Arkansas Poison Center (May 2021 to July 2023) identified adverse drug reactions and presumed anaphylaxis in patients treated with crotaline antivenom. Two allergists (JK, LM), blinded to the antivenom used, adjudicated presumed anaphylaxis cases. To assess whether antivenoms could activate basophils from α-GAL-IgE-sensitized individuals, basophil activation tests were performed on blood from 5 α-GAL-IgE-sensitized participants with a history of mammalian meat allergy. Basophil activation was assessed by %CD63 upregulation.

resultsAdverse drug reactions without presumed anaphylaxis occurred in 7 out of 171 (4.1%) Fab recipients versus 8 out of 37 (21.6%) F(ab')

conclusionWe demonstrate a substantial incidence of adverse drug reactions and presumed anaphylaxis to crotaline antivenoms in an α-GAL endemic region, with F(ab')

Indexed as

AnaphylaxisAntiveninsImmunoglobulin Fab FragmentsAdultAnimalsBasophilsCrotalid VenomsDisaccharidesFemaleFood HypersensitivityHumansMaleMiddle AgedPrevalenceRetrospective StudiesSnake BitesAntiveninsCrotalidae Polyvalent immune FabCrotalid VenomsDisaccharidesgalactosyl-(1-3)galactoseImmunoglobulin Fab FragmentsAlpha-galAnaphylaxisGalactose-alpha-1,3-galactoseSnake antiveninSnake antivenom

Identifiers

PMID40817895
PMCPMC13270925

What OpenQuestion holds

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Registered trials

None linked

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.