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DOI: 10.1055/s-0030-1249762
Digoxin Immune Fab Treatment for Severe Preeclampsia
Publication History
Publication Date:
15 March 2010 (online)
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ABSTRACT
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.
KEYWORDS
Digoxin immune Fab - endogenous digitalis-like factors - preeclampsia - sodium pump
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C David Adair M.D.
Professor, University of Tennessee, Chairman, Glenveigh Research
401 Chestnut Street, Suite 230, Chattanooga, TN 37402
Email: David.Adair@Glenveigh.com