- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04470791
Cryotherapy as a Coadjuvant in Crotaline Snakebite Management With Antivenom.
Cryotherapy as a Coadjuvant in the Management of Crotaline Snakebite With F(ab')2 Antivenom: A Randomized Pilot Study.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Introduction: Local cryotherapy induces vasoconstriction, which leads to a reduction in the inflammatory process. However, the efficacy of local cryotherapy as a coadjuvant in snakebite treatment with F(ab')2 antivenom is unknown.
Objective: Determine the effect of local cryotherapy as a coadjuvant in patients with snakebite treated with F(ab')2 therapy venom.
Material and methods: Subjects with snakebite envenomation accident grade II, according to the Christopher-Rodning classification, were enrolled from the Clinical Toxicology Service of the Hospital Juárez de México. One group of patients received F(ab')2 antivenom therapy (antivipmyn®) plus local cryotherapy, and another group received only F(ab')2 antivenom therapy.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients of both genders and any age with a snake bite of poison grade II who were admitted to the Clinical Toxicology Service of the Hospital Juárez de México.
Exclusion Criteria:
- Patients of both genders and any age with a snake bite of poison grade I, III or IV who were admitted to the Clinical Toxicology Service of the Hospital Juárez de México.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: F(ab')2 antivenom plus local cryotherapy.
Group A: patients with a Crotalus snakebite, and grade II envenomation received F(ab')2 antivenom therapy and application of local cryotherapy.
|
Antivipmyn is an equine origin antivenom produced by Institute Bioclon in Mexico (Silanes Laboratories, México).
The snake venoms used to create the F(ab')2 fragments are from Crotalus durissus and Bothrops asper.
The number of doses of each patient depended on the classification and evolution, as indicated by the manufacturer for grade II envenoming: from 6 to 10 bottles of F(ab)2 antivenom therapy, intravenously, as an initial dose.
One dose (bottle) consisted of 10 mL of polyvalent concentrated and modified horse antibodies treated by enzymatic digestion to neutralize the Bothrops asper venom to not less than 780 lethal dose 50 (LD50), and the Crotalus basiliscus venom to not less than 790 LD50.
Interval cryotherapy consisted of applying a plastic bag (the size of the bag depending on the size of the lesion, approximately 28 x 46 cm) two-thirds filled with crushed ice (frapped) wrapped in a towel applied for 20 minutes every 4 hours at the site of the snakebite throughout the hospital stay.
New ice bags were used after 4 hours.
|
Active Comparator: F(ab')2 antivenom.
Group B: patients who received only F(ab')2 antivenom therapy.
|
Antivipmyn is an equine origin antivenom produced by Institute Bioclon in Mexico (Silanes Laboratories, México).
The snake venoms used to create the F(ab')2 fragments are from Crotalus durissus and Bothrops asper.
The number of doses of each patient depended on the classification and evolution, as indicated by the manufacturer for grade II envenoming: from 6 to 10 bottles of F(ab)2 antivenom therapy, intravenously, as an initial dose.
One dose (bottle) consisted of 10 mL of polyvalent concentrated and modified horse antibodies treated by enzymatic digestion to neutralize the Bothrops asper venom to not less than 780 lethal dose 50 (LD50), and the Crotalus basiliscus venom to not less than 790 LD50.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Distal circumference of the affected limb on hospital admission.
Time Frame: Baseline.
|
The circumference values of the injured limb were measured in the distal circumference (site farthest from the bite with the estimated maximum degree of edema, or at the end of the limb) on the affected extremity.
|
Baseline.
|
Proximal circumference of the affected limb on hospital admission.
Time Frame: Baseline.
|
The circumference values of the injured limb were measured in the proximal circumference (5-10 cm from the site of the bite) on the affected extremity.
|
Baseline.
|
Middle circumference of the affected limb on hospital admission.
Time Frame: Baseline.
|
The circumference values of the injured limb were measured in the middle circumference (intermediate measurement between the proximal and distal diameter) on the affected extremity.
|
Baseline.
|
Distal circumference of the affected limb on hospital admission.
Time Frame: up to 24 weeks
|
The circumference values of the injured limb were measured in the distal circumference (site farthest from the bite with the estimated maximum degree of edema, or at the end of the limb) on the affected extremity.
The measurement was recorded at the time of the patient's hospital discharge.
|
up to 24 weeks
|
Proximal circumference of the affected limb on hospital admission.
Time Frame: up to 24 weeks.
|
The circumference values of the injured limb were measured in the proximal circumference (5-10 cm from the site of the bite) on the affected extremity.
The measurement was recorded at the time of the patient's hospital discharge.
|
up to 24 weeks.
|
Middle circumference of the affected limb on hospital admission.
Time Frame: up to 24 weeks.
|
The circumference values of the injured limb were measured in the middle circumference (intermediate measurement between the proximal and distal diameter) on the affected extremity.
The measurement was recorded at the time of the patient's hospital discharge.
|
up to 24 weeks.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hospital stay.
Time Frame: up to 24 weeks.
|
The length of an inpatient episode of care, calculated from the day of admission to day of discharge, and based on the number of nights spent in hospital.
Patients admitted and discharged on the same day have a length of stay of less than one day.
|
up to 24 weeks.
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HJM 0142/16-R (Other Identifier: Hospital Juárez de México)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Snake Bites
-
Institut PasteurCentre Pasteur du Cameroun; Cameroon Society of Epidemiology (CaSE); Centre International... and other collaboratorsCompleted
-
BTG International Inc.Completed
-
Jawaharlal Institute of Postgraduate Medical Education...Unknown
-
BTG International Inc.Completed
-
CTUCompleted
-
Hanoi Medical UniversityKarolinska Institutet; Swedish International Development Cooperation Agency...Completed
-
Ophirex, Inc.Premier Research Group plcCompletedSnakebites | Envenoming | Envenoming, Snake | Envenomation, SnakeUnited States, India
-
EpicentreMedecins Sans Frontieres, NetherlandsWithdrawn
-
Instituto Bioclon S.A. de C.V.Terminated
-
Instituto Bioclon S.A. de C.V.University of Arizona; Universidad Nacional Autonoma de MexicoCompleted
Clinical Trials on F(ab)2 antivenom therapy (antivipmyn®).
-
Instituto Bioclon S.A. de C.V.Terminated
-
Instituto Bioclon S.A. de C.V.Centre Antipoison et de Pharmacovigilane du Maroc; Institut Pasteur du MarocCompletedPoisoning by Scorpion StingMorocco
-
Jubilee Mission Medical College and Research InstituteCompletedEnvenomation, Snakebite | EnvenomationIndia
-
Administracion Nacional de Laboratorios e Institutos...RecruitingCovid19 | COVID-19 Pneumonia | COVID-19 Respiratory InfectionArgentina
-
Vastra Gotaland RegionThe Swedish Research Council; Sahlgrenska University Hospital, Sweden; Swedish...Completed
-
University of ArizonaCompletedCoral Snake Bite | Toxic Effect of Coral Snake VenomUnited States
-
Swiss Group for Clinical Cancer ResearchImmunophotonics, Inc.RecruitingAdvanced Solid TumorsSwitzerland
-
Instituto Bioclon S.A. de C.V.University of ArizonaCompletedScorpion Sting EnvenomationUnited States
-
Duke UniversityCompletedMetastatic CancerUnited States
-
Instituto Bioclon S.A. de C.V.University of Arizona; Universidad Nacional Autonoma de MexicoCompletedScorpion StingUnited States