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Low dose versus high dose of Indian polyvalent snake antivenom in reversing neurotoxic paralysis in common krait (Bungarus cearulus) bites: an open labeled randomised controlled clinical trial in Sri Lanka

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SLCTR Registration Number

SLCTR/2010/006


Date of Registration

02 Jul 2010

The date of last modification

Mar 03, 2019


Trial Status



Application Summary


Scientific Title of Trial

Low dose versus high dose of Indian polyvalent snake antivenom in reversing neurotoxic paralysis in common krait (Bungarus cearulus) bites: an open labeled randomised controlled clinical trial in Sri Lanka


Public Title of Trial

To find appropriate dose of antivenom(low dose/high dose regimen) for common krait bite in Sri Lanka


Disease or Health Condition(s) Studied

Snake bite and antivenom treatment


Scientific Acronym

None


Public Acronym

None


Brief title

None


Universal Trial Number

None


Any other number(s) assigned to the trial and issuing authority

2010/EC/11 (Research and Ethical Committee of the Faculty of Medicine, University of Peradeniya)


Trial Details


What is the research question being addressed?

To test the efficacy of low dose of antivenom compared to high dose in reversing neurotoxic respiratory paralysis in common krait bite.


Type of study

Interventional


Study design

Allocation

Randomized controlled trial


Masking

Masking not used


Control

Dose comparison


Assignment

Parallel


Purpose

Treatment


Study Phase

Not Available


Intervention(s) planned

The enrolled patients will be treated with snake antiserum (lyophilized polyvalent enzyme-refined, manufactured in India by Vins Bioproduct Limited, Mumbai or Bharat Serums and Vaccines Limited, Ambernath) according to the following dose regimens. Group A (Low dose of antivenom) Ten vials of snake antivenom dissolved in 500 ml of normal saline and infuse over 1 hour. Group B (High dose of antivenom) Twenty vials of snake antivenom dissolved in 500 ml of normal saline and infuse over 1 hour.


Inclusion criteria

  1. Patients with proven common krait bites (with an offending snake or with clear clinical evidence of common krait envenoming)
  2. Older than 12 years of age
  3. Presence of features of envenoming with indications for antivenom

Exclusion criteria

  1. Patients who had snake anti venom treatment earlier.
  2. Patients who are already having or had any neurological diseases e.g. myasthenia gravis, infective polyneuropathy, Alzheimer disease etc.
  3. Patients who presented with ingestion of alcohol


Primary outcome(s)

1.

The duration of mechanical ventilation

[

Time in hours from the onset of intubation to extubation

]

Secondary outcome(s)

1.
  1. Number of patients needed mechanical ventilation
  2. Time gap from antivenom treatment to intubation and ventilation
  3. Time taken to complete reversal of neurotoxic signs (Ptosis, Opthalmoplegia, Neck flexon)
  4. Incidence of secondary complications
  5. Duration of ICU stay
  6. Duration of hospital stay
[

From the time of recruitment

]

Target number/sample size

1. Initialy 60 patients will be randomised to two arms of treatment 2. Depending on result of the initial phase, target sample size will be calculated for continuation study


Countries of recruitment

Sri Lanka


Anticipated start date

2010-06-01


Anticipated end date

2011-05-31


Date of first enrollment


Date of study completion


Recruitment status

Recruiting


Funding source

None


Regulatory approvals



State of Ethics Review Approval


Status

Approved


Date of Approval

2010-02-23


Approval number

2010/EC/11


Details of Ethics Review Committee

Name: Ethics Review Committee, Faculty of Medicine, University of Peradeniya
Institutional Address:Galaha Road, Kandy, Sri Lanka
Telephone:+94-812396361
Email: chairpersonierc@gmail.com

Contact & Sponsor Information


Contact person for Scientific Queries/Principal Investigator

Prof SAM Kularatne
Professor in Medicine,
Department of Medicine, Faculty of Medicine,Peradeniya University, Peradeniya, Sri Lanka
0094 81 2388369
0094 773 420771

samkul@sltnet.lk

Contact Person for Public Queries

Prof SAM Kularatne
Professor in Medicine,
Department of Medicine, Faculty of Medicine,Peradeniya University, Peradeniya, Sri Lanka
0094 81 2388369
0094 773 420771

samkul@sltnet.lk


Primary study sponsor/organization

Prof SAM Kularatne

Department of Medicine, Faculty of Medicine,Peradeniya University, Peradeniya, Sri Lanka
0094 81 2388369

samkul@sltnet.lk

Secondary study sponsor (If any)

None





Trial Completion details


Do the investigators plan to share identified individual clinical trial participant-level data (IPD)?


IPD sharing plan description

Not Available


Study protocol available


Protocol version and date

Not Available


Protocol URL

Not Available


Results summary available

No


Date of posting results


Date of study completion


Final sample size


Date of first publication


Link to results


Brief summary of results