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Obiltoxaximab, a monoclonal antibody against protective antigen (PA), is approved for treatment of inhalational anthrax in combination with antibiotics and for prophylaxis when alternative therapies are not available. The impact of toxin neutralization with obiltoxaximab during pre- and postexposure prophylaxis was explored, and efficacy results that supported the prophylaxis indication are presented here. New Zealand White rabbits and cynomolgus macaques received obiltoxaximab as a single intramuscular or intravenous dose of 2 to 16 mg\/kg of body weight at various times relative to<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Bacillus anthracis<\/jats:named-content>aerosol spore challenge. The primary endpoint was survival, and effect of treatment timing was explored. In rabbits, obiltoxaximab administration 9 h postchallenge singly or combined with a 5-day levofloxacin regimen protected 89% to 100% of animals compared to 33% with levofloxacin monotherapy. In cynomolgus macaques, a single intramuscular dose of 16 mg\/kg obiltoxaximab led to 100% survival when given 1 to 3 days preexposure and 83% to 100% survival when given 18 to 24 h postexposure and prior to systemic bacteremia onset. Obiltoxaximab administration after bacteremia onset resulted in lower (25% to 50%) survival rates reflective of treatment setting. Prophylactic administration of obiltoxaximab before spore challenge or to spore-challenged animals before systemic bacterial dissemination is efficacious in promoting survival, ameliorating toxemia, and inhibiting bacterial spread to the periphery.<\/jats:p>","DOI":"10.1128\/aac.01102-16","type":"journal-article","created":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T02:39:00Z","timestamp":1468895940000},"page":"5796-5805","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":46,"title":["Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax"],"prefix":"10.1128","volume":"60","author":[{"given":"Brent J.","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette M.","family":"Shadiack","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sanford","sequence":"additional","affiliation":[{"name":"Battelle, West Jefferson, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa N.","family":"Henning","sequence":"additional","affiliation":[{"name":"Battelle, West Jefferson, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie S.","family":"Casey","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalya V.","family":"Serbina","sequence":"additional","affiliation":[{"name":"Elusys Therapeutics, Inc., Pine Brook, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)63697-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-4-200602210-00009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1504248"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6404a1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2002.130687"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.01.054"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2007.11.085"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.01320"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nbt0602-597"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M301154200"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.73.2.795-802.2005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.LAB.0000080599.43791.01"},{"key":"e_1_3_2_14_2","first-page":"982","article-title":"The pathology of experimental anthrax in rabbits exposed by inhalation and subcutaneous inoculation","volume":"122","author":"Zaucha GM","year":"1998","unstructured":"Zaucha GM, Pitt LM, Estep J, Ivins BE, Friedlander AM. 1998. 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