SNAKEBITES IN CAMEROON: TOLERANCE OF A SNAKE ANTIVENOM (Inoserp™ PAN-AFRICA) IN AFRICA IN RE-AL-LIFE CONDITIONS

Snakebite envenomation (SBE) is a public health issue in sub-Saharan countries. Antivenom is the only etiological treatment. Excellent tolerance is essential to manage SBE successfully. This study aimed to evaluate tolerance of InoserpTM PAN-AFRICA (IPA). It was conducted on fourteen sites across Cameroon. IPA was administered intravenously and repeated at the same dose every two hours if needed. Early and late tolerance was assessed by the onset of clinical signs within two hours and at a visit two weeks or more after the first IPA administration, respectively. Over 20 months, 447 patients presenting with a snakebite were included. One dose of IPA was administered to 361 patients and repeated at least once in 106 patients. No significant difference was shown between the proportion of adverse events in patients who received IPA (266/361, 73.7%) and those who did not (69/85, 81.2%) (p=0.95). Adverse reactions, probably attributable to IPA, were identified in four (1.1%) patients, including one severe (angioedema) and three mild. All these reactions resolved favorably. None of serious adverse events observed in twelve patients were attributed to IPA. No signs of late intolerance were observed in 301 patients. Tolerance appears to be excellent. The availability of effective and well-tolerated antivenoms would reduce the duration of treatment and prevent most disabilities and/or deaths.蛇咬伤中毒（Snakebite envenomation, SBE）是撒哈拉以南国家的公共卫生问题。抗蛇毒血清是唯一的病因治疗手段。要成功救治蛇咬伤中毒患者，良好的耐受性是至关重要的前提。本研究旨在评估InoserpTM泛非抗蛇毒血清（InoserpTM PAN-AFRICA, IPA）的耐受性。该研究在喀麦隆境内的14个研究站点开展。IPA采用静脉给药方式，若临床需要，可每2小时以相同剂量重复给药。早期与晚期耐受性分别通过首次给药后2小时内出现的临床体征，以及首次给药后2周及以上随访时的体征进行评估。在20余个月的研究周期内，共纳入447名蛇咬伤患者。其中361名患者仅接受单次IPA给药，106名患者至少接受1次重复给药。接受IPA治疗的患者不良事件发生率（266/361，73.7%）与未接受治疗者（69/85，81.2%）之间无显著统计学差异（p=0.95）。4名（1.1%）患者出现疑似与IPA相关的不良反应，其中1例为严重不良反应（血管性水肿），3例为轻度不良反应，所有上述反应均已完全好转。12名患者出现严重不良事件，但均未被归因于IPA。301名患者未观察到晚期不耐受体征。 IPA的耐受性表现优良。若能获取有效且耐受性良好的抗蛇毒血清，将缩短治疗时长，并可预防大多数残疾和/或死亡病例的发生。