Evidence map›Paper›PMID 40892140›Full record

ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2025

Comparison of Crotalidae Immune F(ab')2 (Equine) and Crotalidae Polyvalent Immune Fab (Ovine) at Establishing Control of Initial Envenomation Symptoms in Louisiana Agkistrodon Envenomations.

Taylor Sanders, Christine Murphy, Greggory Davis, Christina Aspinwall, Lauren Theriot, Christopher McVicker, Thomas Arnold

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

Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

7 authors.

Taylor SandersEmergency Medicine Residency Program, Louisiana State University Health Sciences Center School of Medicine - New Orleans, Baton Rouge Branch Campus, 5246 Brittany Drive, MEIC Building, 3rd Floor, Baton Rouge, LA, 70808, USA. tsande@lsuhsc.edu.ORCID http://orcid.org/0000-0002-4565-9795
Christine MurphyDepartment of Emergency Medicine, Division of Medical Toxicology, Atrium Health's Carolinas Medical Center, 1000 Blythe Blvd., Charlotte, NC, 28203, USA.
Greggory DavisEmergency Medicine Residency Program, Louisiana State University Health Sciences Center School of Medicine - New Orleans, Baton Rouge Branch Campus, 5246 Brittany Drive, MEIC Building, 3rd Floor, Baton Rouge, LA, 70808, USA.
Christina AspinwallOur Lady of the Lake Regional Medical Center, 5000 Hennessy Blvd., Baton Rouge, LA, 70808, USA.
Lauren TheriotEmergency Medicine Residency Program, Louisiana State University Health Sciences Center School of Medicine - New Orleans, Baton Rouge Branch Campus, 5246 Brittany Drive, MEIC Building, 3rd Floor, Baton Rouge, LA, 70808, USA.
Christopher McVickerEmergency Medicine Residency Program, Louisiana State University Health Sciences Center School of Medicine - New Orleans, Baton Rouge Branch Campus, 5246 Brittany Drive, MEIC Building, 3rd Floor, Baton Rouge, LA, 70808, USA.
Thomas ArnoldDepartment of Emergency Medicine, LSU Health Shreveport, 1501 Kings Highway, PO Box 33932, Shreveport, LA, 71130-3932, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCopperheads and cottonmouths are responsible for most snake envenomations in Louisiana. While the United States Food and Drug Administration has approved both Crotalidae polyvalent immune Fab (FabAV) and Crotalidae immune F(ab')

methodsThis is a retrospective study comparing FabAV to Fab2AV in the treatment of suspected Agkistrodon envenomations in Louisiana between April 2017 and October 2024. Cases identifying rattlesnakes were excluded. The primary outcome was the need for additional antivenom doses to achieve control after the initial antivenom dose.

resultsOne hundred fifty-eight patients received FabAV or Fab2AV, with 100 cases meeting inclusion criteria. Fifty-seven patients received FabAV and 43 received Fab2AV. The snake was identified as copperhead in 48 cases, cottonmouth in 23, and unidentified in 29. In the FabAV cohort, the initial number of vials ranged from four to 12 with a median dose of four vials. Nine FabAV cases (16%) required additional vials for initial control after the first dose. In the Fab2AV cohort, all patients received 10 vials initially, with 24 cases (56%) requiring additional vials for initial control after the first dose. There was a significant difference in the percentage of patients requiring additional control vials between FabAV and Fab2AV.

conclusionIn this cohort of suspected Agkistrodon envenomations, control with initial recommended dosing was more often achieved with FabAV compared to Fab2AV (84% vs. 44%). The results suggest potential benefit to hospitals stocking FabAV in Louisiana and possibly other Agkistrodon-predominant regions.

Indexed as

AgkistrodonAntiveninsCrotalid VenomsImmunoglobulin Fab FragmentsImmunoglobulin FragmentsSnake BitesAdolescentAdultAgedAnimalsChildChild, PreschoolFemaleHumansLouisianaMaleAntiveninsCrotalidae Polyvalent immune FabCrotalid VenomsImmunoglobulin Fab FragmentsImmunoglobulin FragmentsAgkistrodon envenomationAntivenomCopperhead envenomationCottonmouth envenomationSnakebite

Identifiers

PMID40892140
PMCPMC12511506

What OpenQuestion holds

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Registered trials

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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.