Considerations for the development of a field-based medical device for the administration of adjunctive therapies for snakebite envenoming

IF 3.6 Q2 TOXICOLOGY Toxicon: X Pub Date : 2023-08-19 DOI:10.1016/j.toxcx.2023.100169
R. Marshall Werner, Allison N. Soffa
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Abstract

The timely administration of antivenom is the most effective method currently available to reduce the burden of snakebite envenoming (SBE), a neglected tropical disease that most often affects rural agricultural global populations. There is increasing interest in the development of adjunctive small molecule and biologic therapeutics that target the most problematic venom components to bridge the time-gap between initial SBE and the administration of antivenom. Unique combinations of these therapeutics could provide relief from the toxic effects of regional groupings of medically relevant snake species. The application a PRISMA/PICO literature search methodology demonstrated an increasing interest in the rapid administration of therapies to improve patient symptoms and outcomes after SBE. Advice from expert interviews and considerations regarding the potential routes of therapy administration, anatomical bite location, and species-specific venom delivery have provided a framework to identify ideal metrics and potential hurdles for the development of a field-based medical device that could be used immediately after SBE to deliver adjunctive therapies. The use of subcutaneous (SC) or intramuscular (IM) injection were identified as potential routes of administration of both small molecule and biologic therapies. The development of a field-based medical device for the delivery of adjunctive SBE therapies presents unique challenges that will require a collaborative and transdisciplinary approach to be successful.

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开发一种用于蛇咬环境辅助治疗的现场医疗设备的考虑因素
及时服用抗蛇毒血清是目前减轻蛇咬伤中毒负担的最有效方法,蛇咬伤是一种被忽视的热带疾病,最常影响全球农村农业人口。人们对开发针对最有问题的毒液成分的辅助小分子和生物疗法越来越感兴趣,以弥补初始SBE和抗蛇毒血清给药之间的时间差距。这些疗法的独特组合可以减轻医学相关蛇种区域分组的毒性影响。PRISMA/PICO文献检索方法的应用表明,人们对快速给予治疗以改善SBE后患者症状和结果越来越感兴趣。专家访谈的建议和关于潜在治疗给药途径、解剖咬合位置和物种特异性毒液递送的考虑,为开发可在SBE后立即用于提供辅助治疗的现场医疗设备提供了一个框架,以确定理想的指标和潜在障碍。皮下(SC)或肌肉内(IM)注射被确定为小分子和生物疗法的潜在给药途径。用于辅助SBE治疗的现场医疗设备的开发提出了独特的挑战,需要合作和跨学科的方法才能取得成功。
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来源期刊
Toxicon: X
Toxicon: X Pharmacology, Toxicology and Pharmaceutics-Toxicology
CiteScore
6.50
自引率
0.00%
发文量
33
审稿时长
14 weeks
期刊最新文献
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