{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T21:54:53Z","timestamp":1775598893923,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["J3-2534"],"award-info":[{"award-number":["J3-2534"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P3-0019"],"award-info":[{"award-number":["P3-0019"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P1-0207"],"award-info":[{"award-number":["P1-0207"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004488","name":"Croatian Science Foundation","doi-asserted-by":"publisher","award":["UIP-2020-02-1317"],"award-info":[{"award-number":["UIP-2020-02-1317"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: In Europe, Vipera ammodytes ammodytes (Vaa, nose-horned viper) is considered the most venomous of the European vipers. The antivenom Viperfav\u00ae, composed of polyvalent equine F(ab\u2032)2 fragments, is effective against Vipera aspis, Vipera berus and Vaa. Objectives: This study aimed to evaluate the clinical efficacy and pharmacokinetics of Viperfav in Vaa envenomations. Methods: Patients presenting with Vaa snakebite and treated with intravenous Viperfav were included. Clinical manifestations and laboratory findings were assessed on admission to the Emergency Department, prior to antivenom therapy, and monitored throughout hospitalization. Blood samples were collected on arrival and at defined intervals after Viperfav administration. Venom and antivenom concentrations in serum were determined by ELISA and subjected to pharmacokinetic analysis. Results: Twenty-one patients bitten by Vaa and classified with a severity score of 2b on the modified Audebert clinical severity scale received a single intravenous dose of Viperfav within 4 h of the bite. Viperfav attenuated the progression of local symptoms and prevented the development of new systemic manifestations. The serum concentrations of F(ab\u2032)2 fragments reached 196 \u00b5g\/mL, far exceeding the venom concentration at admission (35 ng\/mL). The prolonged elimination half-life of Viperfav (49 h) corresponded with the absence of recurrent symptoms after a single dose. Bradycardia or hypotension occurred in 10% of patients; no cases of anaphylaxis or serum sickness were observed. Conclusions: A single intravenous dose of Viperfav demonstrated clinical efficacy and a favourable pharmacokinetic profile in Vaa envenomed patients when administered within hours of the bite.<\/jats:p>","DOI":"10.3390\/pharmaceutics17111431","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:09:47Z","timestamp":1762358987000},"page":"1431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Efficacy and Pharmacokinetics of Antivenom Viperfav\u00ae in Vipera ammodytes ammodytes Envenomation"],"prefix":"10.3390","volume":"17","author":[{"given":"Tihana","family":"Kurtovi\u0107","sequence":"first","affiliation":[{"name":"Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6545-6805","authenticated-orcid":false,"given":"Mojca","family":"Dobaja Borak","sequence":"additional","affiliation":[{"name":"Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zalo\u0161ka cesta 7, SI-1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damjan","family":"Grenc","sequence":"additional","affiliation":[{"name":"Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zalo\u0161ka cesta 7, SI-1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9854-9955","authenticated-orcid":false,"given":"Adrijana","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Department of Molecular and Biomedical Sciences, Jo\u017eef Stefan Institute, Jamova 39, SI-1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-0708","authenticated-orcid":false,"given":"Igor","family":"Kri\u017eaj","sequence":"additional","affiliation":[{"name":"Department of Molecular and Biomedical Sciences, Jo\u017eef Stefan Institute, Jamova 39, SI-1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Luk\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Infectious Diseases, University Hospital of Split, \u0160oltanska 1, HR-21000 Split, Croatia"},{"name":"School of Medicine, University of Split, \u0160oltanska 2, HR-21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7370-0997","authenticated-orcid":false,"given":"Beata","family":"Halassy","sequence":"additional","affiliation":[{"name":"Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8493-3638","authenticated-orcid":false,"given":"Miran","family":"Brvar","sequence":"additional","affiliation":[{"name":"Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zalo\u0161ka cesta 7, SI-1000 Ljubljana, Slovenia"},{"name":"Centre for Clinical Physiology, Faculty of Medicine, University of Ljubljana, Zalo\u0161ka cesta 4, SI-1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.toxicon.2011.10.008","article-title":"Epidemiology of snakebites in Europe: A systematic review of the literature","volume":"59","author":"Chippaux","year":"2012","journal-title":"Toxicon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1021\/js9701824","article-title":"Preclinical assessment of immunoreactivity of a new purified equine F(ab\u2019)2 against European viper venom","volume":"87","author":"Lutsch","year":"1998","journal-title":"J. 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