Abstract | OBJECTIVES: METHODS: The authors searched PubMed, Ovid MEDLINE, and EMBASE from January 1, 1997, to September 20, 2010, for English-language medical literature and cross-referenced bibliographies of reviewed articles. The published abstracts of the major toxicology conferences were also searched. All prospective and retrospective cohort studies with patients receiving FabAV therapy for North American crotaline envenomations were eligible for data abstraction. Two content experts reviewed full-text articles and extracted relevant study design and outcome data. Proportions of immediate hypersensitivity and serum sickness for each study were analyzed in a random-effects model to produce an overall estimate of immediate hypersensitivity and serum sickness incidence associated with FabAV administration. RESULTS: The literature search revealed 11 unique studies of patients who received FabAV that contained information on immediate hypersensitivity reactions and serum sickness. The meta-analysis produced a combined estimate of the incidence of immediate hypersensitivity of 0.08 (95% confidence interval [CI] = 0.05 to 0.11) and a combined estimate of the incidence of serum sickness of 0.13 (95% CI = 0.07 to 0.21). CONCLUSIONS: In this systematic literature review and meta-analysis, the combined estimates of the incidence of immediate hypersensitivity reactions and serum sickness from FabAV in the treatment of symptomatic North American crotaline envenomations appear to be lower than previously reported, at 0.08 and 0.13, respectively.
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Authors | Tammi H Schaeffer, Vaishali Khatri, Liza M Reifler, Eric J Lavonas |
Journal | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
(Acad Emerg Med)
Vol. 19
Issue 2
Pg. 121-31
(Feb 2012)
ISSN: 1553-2712 [Electronic] United States |
PMID | 22320362
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Copyright | © 2012 by the Society for Academic Emergency Medicine. |
Chemical References |
- Antivenins
- Crotalidae Polyvalent immune Fab
- Immunoglobulin Fab Fragments
- Immunoglobulin Fragments
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Topics |
- Animals
- Antivenins
(adverse effects)
- Humans
- Hypersensitivity, Immediate
(chemically induced, epidemiology)
- Immunoglobulin Fab Fragments
- Immunoglobulin Fragments
(adverse effects)
- Incidence
- Serum Sickness
(chemically induced, epidemiology)
- Snake Bites
(drug therapy, epidemiology)
- United States
(epidemiology)
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