CroFab
Encyclopedia
CroFab is the commercial
name for a Crotalidae Polyvalent Immune Fab (Ovine) snake antivenom, indicated for minimal or moderate North American Crotalid (Rattlesnake
, Copperhead
and Cottonmouth/Water moccasin
) snake envenomation. It is developed and manufactured by BTG plc (formerly Protherics PLC), and distributed in the US by Nycomed Inc. Crotalid snakebites can range from mild to life-threatening, depending on the size and type of snake, the amount of venom injected and the location of the bite. This in turn determines the number of vials of CroFab that are required by the patient. Untreated, the snake venom can cause severe pain and tissue damage that can result in the loss of a limb or even death. Prompt (within 6 hours of snake bite) treatment with CroFab is recommended.
CroFab has been well received by physicians because of its efficacy and safety profile. This has encouraged doctors to treat more bite victims, including patients with milder bites, as well as to start treatment with CroFab earlier in the course of poisoning to reduce its severity.
, rash
or pruritus), which occurred in 14 out of 42 patients. Three patients experienced a serious adverse event. Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment. One patient had a recurrent coagulopathy
due to envenomation, which required re-hospitalisation and additional antivenin administration. In clinical trials, recurrent coagulopathy (the return of a coagulation abnormality after it has been successfully treated with antivenin), characterised by decreased fibrinogen
, decreased platelets and elevated prothrombin time, occurred in approximately half of the patients studied. Recurrent coagulopathy may persist for one to two weeks or more. One patient discontinued CroFab therapy due to an allergic reaction. Patients with allergies to papain
, chymopapain
, other papaya extracts or the pineapple enzyme bromelain
may also be at risk for an allergic reaction to CroFab.
Commerce
While business refers to the value-creating activities of an organization for profit, commerce means the whole system of an economy that constitutes an environment for business. The system includes legal, economic, political, social, cultural, and technological systems that are in operation in any...
name for a Crotalidae Polyvalent Immune Fab (Ovine) snake antivenom, indicated for minimal or moderate North American Crotalid (Rattlesnake
Rattlesnake
Rattlesnakes are a group of venomous snakes of the genera Crotalus and Sistrurus of the subfamily Crotalinae . There are 32 known species of rattlesnake, with between 65-70 subspecies, all native to the Americas, ranging from southern Alberta and southern British Columbia in Canada to Central...
, Copperhead
Agkistrodon contortrix
Agkistrodon contortrix is a species of venomous snake found in North America, a member of the Crotalinae subfamily. The more common name for the species is "copperhead". The behavior of Agkistrodon contortrix may lead to accidental encounters with humans...
and Cottonmouth/Water moccasin
Agkistrodon piscivorus
Agkistrodon piscivorus is a venomous snake, a species of pit viper, found in the southeastern United States. Adults are large and capable of delivering a painful and potentially fatal bite. When antagonized they will stand their ground by coiling their bodies and displaying their fangs...
) snake envenomation. It is developed and manufactured by BTG plc (formerly Protherics PLC), and distributed in the US by Nycomed Inc. Crotalid snakebites can range from mild to life-threatening, depending on the size and type of snake, the amount of venom injected and the location of the bite. This in turn determines the number of vials of CroFab that are required by the patient. Untreated, the snake venom can cause severe pain and tissue damage that can result in the loss of a limb or even death. Prompt (within 6 hours of snake bite) treatment with CroFab is recommended.
CroFab has been well received by physicians because of its efficacy and safety profile. This has encouraged doctors to treat more bite victims, including patients with milder bites, as well as to start treatment with CroFab earlier in the course of poisoning to reduce its severity.
Adverse events
The most common adverse events reported in clinical studies were mild or moderate reactions involving the skin and appendages (primarily urticariaUrticaria
Urticaria is a kind of skin rash notable for pale red, raised, itchy bumps. Hives is frequently caused by allergic reactions; however, there are many non-allergic causes...
, rash
Rash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
or pruritus), which occurred in 14 out of 42 patients. Three patients experienced a serious adverse event. Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment. One patient had a recurrent coagulopathy
Coagulopathy
Coagulopathy is a condition in which the blood’s ability to clot is impaired. This condition can cause prolonged or excessive bleeding, which may occur spontaneously or following an injury or medical and dental procedures.The normal clotting process depends on the interplay of various proteins in...
due to envenomation, which required re-hospitalisation and additional antivenin administration. In clinical trials, recurrent coagulopathy (the return of a coagulation abnormality after it has been successfully treated with antivenin), characterised by decreased fibrinogen
Fibrinogen
Fibrinogen is a soluble plasma glycoprotein, synthesised by the liver, that is converted by thrombin into fibrin during blood coagulation. This is achieved through processes in the coagulation cascade that activate the zymogen prothrombin to the serine protease thrombin, which is responsible for...
, decreased platelets and elevated prothrombin time, occurred in approximately half of the patients studied. Recurrent coagulopathy may persist for one to two weeks or more. One patient discontinued CroFab therapy due to an allergic reaction. Patients with allergies to papain
Papain
Papain, also known as papaya proteinase I, is a cysteine protease enzyme present in papaya and mountain papaya .-Papain family:...
, chymopapain
Chymopapain
Chymopapain is a proteolytic enzyme isolated from the latex of papaya , it is a medication used to treat slipped lower lumbar discs in the spine. Chymopapain injections should preferably be given under local, rather than general, anaesthesia...
, other papaya extracts or the pineapple enzyme bromelain
Bromelain
Bromelain is a pineapple extract thought to be effective for reducing swelling , especially of the nose and sinuses, after surgery or injury. It may also be used for a variety of other effects that remain scientifically unconfirmed and not authorized by regulatory authorities like the Food and Drug...
may also be at risk for an allergic reaction to CroFab.