Digoxin immune fab treatment for severe preeclampsia

C. David Adair, Vardaman M. Buckalew, Steven W. Graves, Garrett K. Lam, Donna D. Johnson, George Saade, David F. Lewis, Christopher Robinson, Theodore M. Danoff, Nikhil Chauhan, Moana Hopoate-Sitake, Kathy B. Porter, Rachel G. Humphrey, Kenneth F. Trofatter, Erol Amon, Suzanne Ward, Lizbeth Kennedy, Lorrie Mason, J. Andrew Johnston

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)655-662
Number of pages8
JournalAmerican Journal of Perinatology
Issue number8
StatePublished - 2010


  • Digoxin immune Fab
  • endogenous digitalis-like factors
  • preeclampsia
  • sodium pump

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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