New Antivenin Pill Could Change the Way Snakebites are Treated
BY Herschel Smith
2 years, 5 months ago
F&S.
A new pill undergoing trials at Duke University may be the answer to poisonous snakebites. Currently, snakebite victims need specific antivenin for the species they were bit by, and that medicine needs to be administered intravenously at a hospital. The antivenin called varespladib-methy in pill form may change that, curing a broad spectrum of bites from different snakes.
According to the World Health Organization, an estimated 2.7 million people get bit by venomous snakes each year around the world. Venomous snakes kill between 81,000 and 138,000 people annually and leave three times that many people with disabilities. Many victims are struck in remote, rural areas with limited access to antivenin, making time one of the biggest factors in saving those bitten by snakes. But researchers hope that a pill-form antivenin would change that.
“Unlike specific [antivenin] therapies, the potential benefit of varespladib is not limited to one or a few snakes,” Dr. Tim Platts-Mills, chief medical officer Ophirex—the drug manufacturer trying to develop oral antivenin—told The News & Observer. Researchers say that the pill could also be administered on-site no matter where a person is when they get get bit.
Researchers also think that the pill could lower the high cost of antivenin treatments, which run anywhere from $76,000 to over $100,000 without insurance. It would do this by reducing the amount of intravenous antivenin that needs to be administered, reducing the need for painkillers, and shortening hospital stays for victims.
“It’ll be a pretty long time before we know if the pill alone can be the treatment, but there are a number of ways the pill can work to reduce costs,” says Dr. Charles Gerardo, an emergency medicine specialist at Duke.
Six research sites in the U.S. and six in India will evaluate the effectiveness of the pill. The Americans will look at how the pill works for the two types of venomous snakes found in the U.S.—pit vipers and coral snakes—and Indian researchers will look into bites from other venomous snakes.
I’m not sure what “pretty long time” means, and I don’t like the sound of that. But I do like the idea of something other than what we currently use. I’ll communicate with the doctor and see if I can’t dig up some more facts.
For those of you who don’t currently know anything about how this all goes down, I do know a little something. My dog Heidi always had a penchant for messing with snakes. It was something pathological about her. She started pawing at a Copperhead one night on a walk and got bitten in the paw.
It swelled up the size of a softball and I feared she would lose the leg, or part of it. The emergency Vet I took her to gave her some anti-inflammatory medicine and antibiotics and sent her home. I slept with her that night. She was pitiful. She recovered though.
When I asked the Vet about antivenin and studied it later, as it turns out each treatment of that stuff ranged up to $15,000 (at that time, several years ago). It is biological material and degrades with time, and they don’t give it to animals. I wouldn’t have been able to afford it anyway.
They create antivenin by injecting cattle (usually in Mexico) with small amounts of snake venom and then extracting the blood products over time after the cattle have adapted to it. For it to be viable, it has to be refrigerated. This isn’t something every hospital has sitting around (sometimes it has to be delivered via a “life flight”), and even if most or all did, snakes bite at the most inopportune time, well away from hospitals.
If Heidi had gotten bitten by a Rattlesnake, she would have been dead within minutes or perhaps a couple of hours. So would a human without treatment. Oftentimes, humans lose arms, legs, or other body parts, when bitten by Rattlesnakes. Water Moccasins (Cottonmouths) also kill with a neurotoxin. Copperheads aren’t quite the deadly threat that Rattlesnakes or Water Moccasins are, but in order to keep from losing appendages, you have to seek treatment.
A tablet like they’re describing would go a long way towards reducing the cost of this treatment and expand its availability when most needed.
As I said, I’ll try to communicate with the doctor and find out more. For those of us to bang around in the bush or work on farms or ranches, this is important stuff.
UPDATE: Related, a little boy in Colorado was killed by a Rattlesnake.
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On July 11, 2022 at 10:21 pm, Fred said:
I like the sound of a pill too even if it’s only a temporary solution allowing time to aquire hospitalization and full treatment. I would hope that they don’t allow the one pill cures all perfect solution to be the enemy of something that’s still pretty good.
That article is short on details and technical info, which the readership here can certainly handle. I look forward to more depth if you can get it.
On July 12, 2022 at 7:20 am, Eric said:
From what I could find this drug stops damage from PLA2 , which is one of four general categories of toxins in snake venom. Found an article on nih website about the same chemical (without methyl).
Looks like a very promising drug to me.
Varespladib may still be an efficient treatment capable of protecting from PLA2-associated signs of envenoming. In the case of more complex venoms, other enzymes or toxin inhibitors, such as proteinase inhibitors or other antitoxins, are likely to be used simultaneously to prevent local cytotoxic and hemorrhagic effects [1,4].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354479/
On July 12, 2022 at 3:15 pm, Pat Hines said:
Both my wife and I are Registered Nurses, we definitely want this information.
Also, I speak from experience, non-poisonous snake bites warrant treatment including a tetanus shot.