Ten relevant studies were identified (n=47, range one to 24): one RCT (n=4), six case reports and three descriptive reports. The RCT included older patients.
Efficacy and dosing (10 studies): Most patients achieved initial control (63.8% after only one dose). Most (63.8%) patients received additional maintenance doses as recommended by the manufacturer of FabAV; 19.1% patients received at least one additional maintenance dose and 17.0% patients did not receive any maintenance doses and were presumed to have more minor snakebites.
Recurrence of adverse events (nine studies): There were two incidences of recurrence of adverse effects (in 23 patients) following initial control; both patients were given FabAV maintenance doses. Late coagulopathy was reported in four of 23 patients following initial normal values. One retrospective study reported that five of 12 patients had episodes of thrombocytopenia (platelet count <150,000mm) during their hospital stay that did not respond to FabAV treatment.
Safety (10 studies): Three patients (6.4%) developed an acute infusion reaction. Symptoms noted included urticaria, cough, facial/periorbital oedema, voice change and tachycardia. The overall incidence of both acute and late adverse reactions was 8.5%.