New Study Warns of Critical Gaps in Global Snake Antivenom Data

June 30, 2025 — A recently published systematic review in Toxin Reviews exposes serious inconsistencies in the clinical and pharmacological data of commercial snake antivenoms worldwide, raising concerns about their safety, effectiveness, and regulatory oversight. The study examined antivenoms used in seven key regions: Iran, Turkey, Australia, India, Africa, Brazil, and Europe. Despite the global public health significance of snakebite envenomation—estimated to cause up to 138,000 deaths each year—the authors found that most antivenoms lack crucial data on pharmacokinetics and tissue penetration. These gaps make it difficult to determine how well antivenoms are absorbed, distributed, and eliminated in the body, which directly affects patient outcomes. "Shockingly, many commercial antivenoms have never been tested in clinical trials," the authors noted, pointing out that most rely on preclinical animal studies without validation of efficacy in humans. Additionally, many products did not report effective dosing, side effect profiles, or detailed composition.

Key Findings:

• Out of 3,645 initial studies reviewed, only 23 met the inclusion criteria for clinical and pharmacological rigor.

  • Iranian and African antivenoms had the highest rates of acute hypersensitivity and febrile reactions.

  • Australian antivenoms were among the most effective, with accurate dosage recommendations and fewer side effects.

  • Indian and Brazilian antivenoms showed variable efficacy, with several being ineffective against local snake species.

  • European products like ViperaTAb showed promise with lower protein content and fewer side effects, but production of some antivenoms (e.g., Zagreb) has stopped.

Conclusion and Urgent Call to Action:

The review highlights a global need for standardized clinical evaluation of snake antivenoms, especially regarding their pharmacokinetics. The authors call for tighter regulatory harmonization, increased investment in research, and support for local manufacturing in underserved regions to prevent preventable deaths and complications. "Without reliable data on how antivenoms behave in the human body, we're essentially flying blind," said co-author Omid Mehrpour. "Lives are at stake, especially in rural and low-resource settings."

Read the Full Article:

https://doi.org/10.1080/15569543.2025.2521508