TY - JOUR
T1 - Digoxin immune fab treatment for severe preeclampsia
AU - Adair, C. David
AU - Buckalew, Vardaman M.
AU - Graves, Steven W.
AU - Lam, Garrett K.
AU - Johnson, Donna D.
AU - Saade, George
AU - Lewis, David F.
AU - Robinson, Christopher
AU - Danoff, Theodore M.
AU - Chauhan, Nikhil
AU - Hopoate-Sitake, Moana
AU - Porter, Kathy B.
AU - Humphrey, Rachel G.
AU - Trofatter, Kenneth F.
AU - Amon, Erol
AU - Ward, Suzanne
AU - Kennedy, Lizbeth
AU - Mason, Lorrie
AU - Johnston, J. Andrew
PY - 2010
Y1 - 2010
N2 - 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 (310 and 3410 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.
AB - 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 (310 and 3410 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.
KW - Digoxin immune Fab
KW - endogenous digitalis-like factors
KW - preeclampsia
KW - sodium pump
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U2 - 10.1055/s-0030-1249762
DO - 10.1055/s-0030-1249762
M3 - Article
C2 - 20232280
AN - SCOPUS:77955528215
SN - 0735-1631
VL - 27
SP - 655
EP - 662
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 8
ER -