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Incidence of hypersensitivity reactions following copperhead snakebites treated with Fab AV or placebo
S140
Abstracts / Toxicology Letters 259S (2016) S73–S247
PO12.4 Intentional poisonings: Report from the Catholic University Poison Information Center 2006–2015
and finally, in 2015 the reported drug-related intoxications were 30 from 237 cases reported by the Laboratory of Toxicology of the Department of Toxicology of the University of San Carlos of Guatemala. Conclusions: Over the years, the number of intoxications reported by the Department of Toxicology is increasing, as well as the number of intoxications related to drugs of abuse.
C. Reinike 1 , L. Silva 1 , P. Cerda 1 , J.J. Mieres 1 , J.M. Del Campo 1 , E. Paris 1 , J.C. Ríos 1,2
http://dx.doi.org/10.1016/j.toxlet.2016.07.593
1
PO12.3 Incidence of hypersensitivity reactions following copperhead snakebites treated with Fab AV or placebo M.E. Mullins 1 , C.J. Gerardo 2 , E.J. Lavonas 3 , for the Copperhead Envenomation Study Group12 1
Emergency Medicine, Washington University, St. Louis, MO, USA Emergency Medicine, Duke University, Durham, NC, USA 3 Rocky Mountain Poison and Drug Center, Denver, CO, USA 2
Introduction: Risk of adverse reactions to antivenom is a concern for many clinicians. A meta-analysis of patients given ovine-derived Crotalidae polyvalent immune Fab AV (CroFab® , BTG International) conservatively attributed all reactions to the antivenom and estimated immediate hypersensitivity reactions or serum sickness were 8% and 13%, respectively. The comparative incidence of reactions between patients with snakebites of similar severities treated with FabAV or no antivenom remains unknown. Objective: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with FabAV or placebo. Materials and methods: Patients with copperhead snakebites received treatment and follow-up in a prospective, multicenter, randomized, controlled trial of Fab AV or placebo (ClinicalTrials.gov Identifier NCT01864200). The treatment allocation ratio Fab AV:placebo was 2:1. All patients had 24 h of observation with follow-up at 0, 3, 7, 14, 21, and 28 d from discharge. We included all patients who had at least 1 dose of study treatment. We reviewed all treatment-emergent adverse events (TEAEs). We used a previously published scale to classify likely hypersensitivity reactions as mild (skin, subcutaneous tissues only), moderate (respiratory, cardiovascular or gastrointestinal), or severe (hypoxia, hypotension, or neurological compromise). Results: Out of 74 patients (39 M, 35 F) at 12 sites, 45 patients (23 M, 22 F) received FabAV and 29 patients (16 M, 13 F) received placebo. Five of 45 Fab AV patients and 4 of 29 placebo patients had moderate envenomation; all others were mild. There were 25 FabAV patients and 8 placebo patients who had ≥1 TEAE. Mild skin reactions occurred in 11/45 FabAV patients and 1/29 placebo patients. Moderate GI TEAEs occurred in 7/45 FabAV patients and 2/29 of placebo patients. Respiratory TEAEs occurred in 3/45 of FabAV patients and 0 placebo patients. One patient in each group had Hypotension (severe reaction). Conclusions: The incidence of FabAV hypersensitivity reactions is low. Most reactions were mild skin reactions. Financial support: BTG. http://dx.doi.org/10.1016/j.toxlet.2016.07.594
Centro de Información Toxicológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile 2 Department of Clinical Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile Introduction: According to figures from the World Health Organization (WHO), every year, one million people commit suicide worldwide, reaching 1.4% of world morbidity, being one of the leading causes of death in some countries. Suicide attempt by ingestion of toxic substances is a public health concern that requires urgent attention because of the serious consequences that these exposures can cause on health. These exposures include those with suicidal intent which have been increasing in recent years according to international statistics. Objective: The aim of this work was to describe epidemiologically cases involving intentional poisonings in Chilean population received by Centro de Información Toxicologica de la Universidad Católica (CITUC) during the 2006–2015 period. Materials and methods: A descriptive, retrospective study was conducted which included all intentional poisonings received by the center during the given period. The variables analyzed were age, sex, route of exposure, causal agent and interlocutor. Results: A total of 78,330 cases of intentional poisoning (29% of the total cases) were received. Of these, 93% were suicide attempts which involved mainly women (76%), in the adults and adolescents groups (43% and 19%, respectively). The main agent involved were pharmaceuticals products (87%), specially those acting at central nervous system level (27% and 26% antidepressants and anxiolytics, respectively). Females had a 3.3 times higher risk for suicide than males (OR: 3.3; CI95% : 3.2–3.4; p < 0.001). It was noted that between 2006 and 2015 the incidence of suicide attempts increased from 23% to 28%. Conclusions: Intentional poisoning represents a public health concern in Chile. The highest percentage of cases corresponds to suicide attempts. Pharmaceutical products were the main cause specially those active at central nervous system level the main risk group was females. http://dx.doi.org/10.1016/j.toxlet.2016.07.595 PP12.1 Suicides and suicide attempts by antidepressant drug poisonings reported in Costa Rica from 2007 to 2014 M.M. Castillo-Guerrero 1 , M. Gómez-Vargas 1 , B. Scarpa 2 , F. Arias-Mora 1 1 Department of Pharmacology, Toxicology and Pharmacodependence Universidad de Costa Rica, San José, Costa Rica 2 Department of Statistical Sciences, University of Padua, Padua, Italy
Introduction: According to information from the World Health Organization, more than 800,000 people in the world die each year from suicide and many more make suicide attempts. 2012 data, place suicide as the second leading cause of death worldwide among the population aged 15–29 years old. According to the PanAmerican Health Organization, in Central America there has been
Abstracts / Toxicology Letters 259S (2016) S73–S247
PO12.4 Intentional poisonings: Report from the Catholic University Poison Information Center 2006–2015
and finally, in 2015 the reported drug-related intoxications were 30 from 237 cases reported by the Laboratory of Toxicology of the Department of Toxicology of the University of San Carlos of Guatemala. Conclusions: Over the years, the number of intoxications reported by the Department of Toxicology is increasing, as well as the number of intoxications related to drugs of abuse.
C. Reinike 1 , L. Silva 1 , P. Cerda 1 , J.J. Mieres 1 , J.M. Del Campo 1 , E. Paris 1 , J.C. Ríos 1,2
http://dx.doi.org/10.1016/j.toxlet.2016.07.593
1
PO12.3 Incidence of hypersensitivity reactions following copperhead snakebites treated with Fab AV or placebo M.E. Mullins 1 , C.J. Gerardo 2 , E.J. Lavonas 3 , for the Copperhead Envenomation Study Group12 1
Emergency Medicine, Washington University, St. Louis, MO, USA Emergency Medicine, Duke University, Durham, NC, USA 3 Rocky Mountain Poison and Drug Center, Denver, CO, USA 2
Introduction: Risk of adverse reactions to antivenom is a concern for many clinicians. A meta-analysis of patients given ovine-derived Crotalidae polyvalent immune Fab AV (CroFab® , BTG International) conservatively attributed all reactions to the antivenom and estimated immediate hypersensitivity reactions or serum sickness were 8% and 13%, respectively. The comparative incidence of reactions between patients with snakebites of similar severities treated with FabAV or no antivenom remains unknown. Objective: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with FabAV or placebo. Materials and methods: Patients with copperhead snakebites received treatment and follow-up in a prospective, multicenter, randomized, controlled trial of Fab AV or placebo (ClinicalTrials.gov Identifier NCT01864200). The treatment allocation ratio Fab AV:placebo was 2:1. All patients had 24 h of observation with follow-up at 0, 3, 7, 14, 21, and 28 d from discharge. We included all patients who had at least 1 dose of study treatment. We reviewed all treatment-emergent adverse events (TEAEs). We used a previously published scale to classify likely hypersensitivity reactions as mild (skin, subcutaneous tissues only), moderate (respiratory, cardiovascular or gastrointestinal), or severe (hypoxia, hypotension, or neurological compromise). Results: Out of 74 patients (39 M, 35 F) at 12 sites, 45 patients (23 M, 22 F) received FabAV and 29 patients (16 M, 13 F) received placebo. Five of 45 Fab AV patients and 4 of 29 placebo patients had moderate envenomation; all others were mild. There were 25 FabAV patients and 8 placebo patients who had ≥1 TEAE. Mild skin reactions occurred in 11/45 FabAV patients and 1/29 placebo patients. Moderate GI TEAEs occurred in 7/45 FabAV patients and 2/29 of placebo patients. Respiratory TEAEs occurred in 3/45 of FabAV patients and 0 placebo patients. One patient in each group had Hypotension (severe reaction). Conclusions: The incidence of FabAV hypersensitivity reactions is low. Most reactions were mild skin reactions. Financial support: BTG. http://dx.doi.org/10.1016/j.toxlet.2016.07.594
Centro de Información Toxicológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile 2 Department of Clinical Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile Introduction: According to figures from the World Health Organization (WHO), every year, one million people commit suicide worldwide, reaching 1.4% of world morbidity, being one of the leading causes of death in some countries. Suicide attempt by ingestion of toxic substances is a public health concern that requires urgent attention because of the serious consequences that these exposures can cause on health. These exposures include those with suicidal intent which have been increasing in recent years according to international statistics. Objective: The aim of this work was to describe epidemiologically cases involving intentional poisonings in Chilean population received by Centro de Información Toxicologica de la Universidad Católica (CITUC) during the 2006–2015 period. Materials and methods: A descriptive, retrospective study was conducted which included all intentional poisonings received by the center during the given period. The variables analyzed were age, sex, route of exposure, causal agent and interlocutor. Results: A total of 78,330 cases of intentional poisoning (29% of the total cases) were received. Of these, 93% were suicide attempts which involved mainly women (76%), in the adults and adolescents groups (43% and 19%, respectively). The main agent involved were pharmaceuticals products (87%), specially those acting at central nervous system level (27% and 26% antidepressants and anxiolytics, respectively). Females had a 3.3 times higher risk for suicide than males (OR: 3.3; CI95% : 3.2–3.4; p < 0.001). It was noted that between 2006 and 2015 the incidence of suicide attempts increased from 23% to 28%. Conclusions: Intentional poisoning represents a public health concern in Chile. The highest percentage of cases corresponds to suicide attempts. Pharmaceutical products were the main cause specially those active at central nervous system level the main risk group was females. http://dx.doi.org/10.1016/j.toxlet.2016.07.595 PP12.1 Suicides and suicide attempts by antidepressant drug poisonings reported in Costa Rica from 2007 to 2014 M.M. Castillo-Guerrero 1 , M. Gómez-Vargas 1 , B. Scarpa 2 , F. Arias-Mora 1 1 Department of Pharmacology, Toxicology and Pharmacodependence Universidad de Costa Rica, San José, Costa Rica 2 Department of Statistical Sciences, University of Padua, Padua, Italy
Introduction: According to information from the World Health Organization, more than 800,000 people in the world die each year from suicide and many more make suicide attempts. 2012 data, place suicide as the second leading cause of death worldwide among the population aged 15–29 years old. According to the PanAmerican Health Organization, in Central America there has been