Digoxin immune fab treatment for severe preeclampsia.
Author(s): Adair CD, Buckalew VM, Graves SW, Lam GK, Johnson DD, Saade G, Lewis DF, Robinson C, Danoff TM, Chauhan N, Hopoate-Sitake M, Porter KB, Humphrey RG, Trofatter KF, Amon E, Ward S, Kennedy L, Mason L, Johnston JA
Affiliation(s): University of Tennessee, Chattanooga, TN 37402, USA. David.Adair@Glenveigh.com
Publication date & source: 2010-09, Am J Perinatol., 27(8):655-62. Epub 2010 Mar 15.
Publication type: Research Support, Non-U.S. Gov't
We evaluated the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) treatment of severe preeclampsia. Fifty-one severe preeclamptic patients were randomized in double-blind fashion to DIF ( N = 24) or placebo ( N = 27) for 48 hours. Primary outcomes were change in creatinine clearance (CrCl) at 24 to 48 hours and antihypertensive drug use. Serum sodium pump inhibition, a sequela of endogenous digitalis-like factors (EDLF), was also assessed. CrCl in DIF subjects was essentially unchanged from baseline versus a decrease with placebo (-3 +/- 10 and -34 +/- 10 mL/min, respectively, P = 0.02). Antihypertensive use was similar between treatments (46 and 52%, respectively, P = 0.7). Serum sodium pump inhibition was decreased with DIF compared with placebo at 24 hours after treatment initiation (least squares mean difference, 19 percentage points, P = 0.03). DIF appeared to be well tolerated. These results suggest DIF prevents a decline in renal function in severe preeclampsia by neutralizing EDLF. Sodium pump inhibition was significantly improved. Further research is warranted. Copyright Thieme Medical Publishers.