5 ms·

It's unclear to me how much damage the pill prevents versus simply delaying it. I didn't see any clear statements on that in the article and there are a few quo

by rurp 3y ago

It's unclear to me how much damage the pill prevents versus simply delaying it. I didn't see any clear statements on that in the article and there are a few quotes like, "intended to at least buy victims enough time to get to the hospital." If victims still need anti-venom to prevent serious injury then the drug is much less exciting. As the article points out anti-venom treatments are expensive, unreliable, and hard to access; in other words not that great. Having more time to reach that treatment is better than nothing but is hardly world changing. Also, maybe I overly cynical, but I'm skeptical that this medicine will be affordable and accessible to most of the people in poor rural communities that make up the bulk of dangerous bite victims. I do a lot of hiking and, like many folks who do the same, have been within reach of venomous snakes more times than I can count. A pill that can prevent serious damage from a bite would be huge; if it's effective and accessible.

cf1241290841 3y ago
Delaying is already massive seeing as you often cant take anti-venom with you due to refrigeration needs. That delay is likely enough to get you to a clinic. For the cost aspects, as India has shown life saving generics for people who couldnt afford it anyway are always an option. edit: Its also worth mentioning that the "accessible by drone" aspect to reduce treatment times is rarely possible in the rain forests where such bites often occur.
- lupusreal 3y ago
  > edit: Its also worth mentioning that the "accessible by drone" aspect to reduce treatment times is rarely possible in the rain forests where such bites often occur. Given the expenses already involved, it seems to me that single use drones should be on the table. Fixed wing for range, with detachable wings and a hard dense fuselage for penetrating the tree canopy. They'd cost a few thousand a pop.
- liamwire 3y ago
  Even if antivenom was stable at room temperature, that’s far from the only reason you can’t take it with you. Administration challenges, identifying the snake correctly and i.e. the right antivenom to use, variation in doses needed—which may well be multiple vials, the list goes on. Further, even with antivenom administered, a person is likely to experience a range of side effects and symptoms that would be life threatening emergencies even in if they were inside an ICU, let alone out in the field. Without the compliment of an equipped medical professional and supportive care, antivenom may well do more harm than good in the immediate aftermath of envenomation. Far better to get the person out of harms way and follow your local first aid procedure for snakebites. In Australia for example, that’s the pressure immobilisation technique, but in other countries it’ll depend on the venom in question. Rattlesnake venom is often necrotising and a tourniquet may cause more harm. Anything that buys more time is key.
scottyah 3y ago
I didn't see any claims of it being a cure, but I think it still has the ability to be "world changing" for all those who are in need, much the same as a tourniquet doesn't fix loss of limb but can easily save a life when time is the deciding factor. I found more information about the active ingredient (cited in the article) on wikipedia: https://en.wikipedia.org/wiki/Varespladib https://en.wikipedia.org/wiki/Varespladib
- buu700 3y ago
  Seems like it'd be pretty useful if it turned out to be cheap enough to stock in first aid kits and medicine cabinets around the world.
- pmayrgundter 3y ago
  Went digging a bit. It's a "small molecule" (C21-H20-N2-O5) and commercialy available at $10/mg[1]. Presumably this would come down quite a bit if it were widely stocked. The studies say they are looking at doses of 10mg/kg[2]. Similar dosing to a pain pill. On a first read, looks like a partial solution as it only delays onset of venom pathology for a day, tho not sure I'm interpreting that correctly. Otoh, it looks like the pills can continue to be taken for many days.. so perhaps there's promise for the venom to be slowly metabolized somehow that isn't inhibited. Might also bring down the cost of antivenom if it's now feasible to funnel patients into central treatment over greater distances, so stocks could be better used. [1]https://pubchem.ncbi.nlm.nih.gov/compound/155815#section=Chemical-Vendors https://pubchem.ncbi.nlm.nih.gov/compound/155815#section=Che... [2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695340/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695340/ https://clinicaltrials.gov/study/NCT04996264 https://clinicaltrials.gov/study/NCT04996264
bluGill 3y ago
This seems to be about India, so I don't know how my local conditions apply to this pill. For rattlesnake bites the anti-venom has a 3 month shelf life and is expensive. Such snakebites are very rare (at least the local rattlesnake where I live). As such even though most rural areas have more rattlesnakes than humans, the local hospitals don't have anti-venom: most of the time it would expire unused. So if this pill has a better shelf life and gives time to air lift to the nearest large city (which may cover more than one state and likely has other ICU care that small rural hospitals can't provide) it is well worth having around even if it is just a stop gap.
- tourmalinetaco 3y ago
  My professor told me a story related to this. Now he was in WV, working on machines for the coal mines. Dead of winter, like a mile underground. Someone gets bit by a copperhead. At some point it must have hitched a ride on something and got brought into the mine. They had to fly the guy all the way to Columbus, OH to get the anti-venom because no one was stocking it during the Winter.
hansvm 3y ago
In the US that's still crazy exciting. Most of my hikes (at least, before I moved to the Bay), I'd rarely be within a 3h jog of the closest place a chopper could land, and that's assuming you have a satphone or something to actually contact the outside world. Plus, in a ton of states, driving is a privilege, not a right. I've lost my license a few times after the judge in question said I was justified but some bureaucrat in "public safety" or whatever didn't care about the life-threatening issues at hand and just yanked that privilege. Bureaucracy is hard to undo, and even if it weren't strictly a matter of improving my chance to live I'd much much much rather take a pill and a slow, safe route to the hospital than spend one more God-forsaken winter biking to work in -20F.
- sandworm101 3y ago
  Choppers don't need to land. Most of the time a rescue chopper would rather not. Winching you up to them is easier/safer than trying to land at an unprepared location. Even without a winch, they would "long line" you to the nearest road where there is room to land. https://youtu.be/WrllMSTm23c https://youtu.be/WrllMSTm23c https://youtu.be/nJZIDwMGHWc https://youtu.be/nJZIDwMGHWc
  - hansvm 3y ago
    Interesting. I probably could have been a lot safer than anticipated.
  - cf1241290841 3y ago
    Mountain rescue also has the impossibility to land. Here some HD footage from national geographic https://www.youtube.com/watch?v=Lk9QKRM_8Jo https://www.youtube.com/watch?v=Lk9QKRM_8Jo Notice the cut audio track. Giving these people the legal ability to give pain meds cant happen early enough. Mont Blanc helicopter rescue services also make some great documentaries every few years. The situation is even worse for a lot of snake bite victims, as you cant get lifted out of the rain forest.
    - dx034 3y ago
aaron695 3y ago
[dead]

by rurp 3y ago

cf1241290841 3y ago

Delaying is already massive seeing as you often cant take anti-venom with you due to refrigeration needs. That delay is likely enough to get you to a clinic. For the cost aspects, as India has shown life saving generics for people who couldnt afford it anyway are always an option. edit: Its also worth mentioning that the "accessible by drone" aspect to reduce treatment times is rarely possible in the rain forests where such bites often occur.

lupusreal 3y ago
> edit: Its also worth mentioning that the "accessible by drone" aspect to reduce treatment times is rarely possible in the rain forests where such bites often occur. Given the expenses already involved, it seems to me that single use drones should be on the table. Fixed wing for range, with detachable wings and a hard dense fuselage for penetrating the tree canopy. They'd cost a few thousand a pop.
liamwire 3y ago
Even if antivenom was stable at room temperature, that’s far from the only reason you can’t take it with you. Administration challenges, identifying the snake correctly and i.e. the right antivenom to use, variation in doses needed—which may well be multiple vials, the list goes on. Further, even with antivenom administered, a person is likely to experience a range of side effects and symptoms that would be life threatening emergencies even in if they were inside an ICU, let alone out in the field. Without the compliment of an equipped medical professional and supportive care, antivenom may well do more harm than good in the immediate aftermath of envenomation. Far better to get the person out of harms way and follow your local first aid procedure for snakebites. In Australia for example, that’s the pressure immobilisation technique, but in other countries it’ll depend on the venom in question. Rattlesnake venom is often necrotising and a tourniquet may cause more harm. Anything that buys more time is key.

scottyah 3y ago

I didn't see any claims of it being a cure, but I think it still has the ability to be "world changing" for all those who are in need, much the same as a tourniquet doesn't fix loss of limb but can easily save a life when time is the deciding factor. I found more information about the active ingredient (cited in the article) on wikipedia: https://en.wikipedia.org/wiki/Varespladib https://en.wikipedia.org/wiki/Varespladib

buu700 3y ago
Seems like it'd be pretty useful if it turned out to be cheap enough to stock in first aid kits and medicine cabinets around the world.
pmayrgundter 3y ago
Went digging a bit. It's a "small molecule" (C21-H20-N2-O5) and commercialy available at $10/mg[1]. Presumably this would come down quite a bit if it were widely stocked. The studies say they are looking at doses of 10mg/kg[2]. Similar dosing to a pain pill. On a first read, looks like a partial solution as it only delays onset of venom pathology for a day, tho not sure I'm interpreting that correctly. Otoh, it looks like the pills can continue to be taken for many days.. so perhaps there's promise for the venom to be slowly metabolized somehow that isn't inhibited. Might also bring down the cost of antivenom if it's now feasible to funnel patients into central treatment over greater distances, so stocks could be better used. [1]https://pubchem.ncbi.nlm.nih.gov/compound/155815#section=Chemical-Vendors https://pubchem.ncbi.nlm.nih.gov/compound/155815#section=Che... [2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695340/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695340/ https://clinicaltrials.gov/study/NCT04996264 https://clinicaltrials.gov/study/NCT04996264

bluGill 3y ago

This seems to be about India, so I don't know how my local conditions apply to this pill. For rattlesnake bites the anti-venom has a 3 month shelf life and is expensive. Such snakebites are very rare (at least the local rattlesnake where I live). As such even though most rural areas have more rattlesnakes than humans, the local hospitals don't have anti-venom: most of the time it would expire unused. So if this pill has a better shelf life and gives time to air lift to the nearest large city (which may cover more than one state and likely has other ICU care that small rural hospitals can't provide) it is well worth having around even if it is just a stop gap.

tourmalinetaco 3y ago
My professor told me a story related to this. Now he was in WV, working on machines for the coal mines. Dead of winter, like a mile underground. Someone gets bit by a copperhead. At some point it must have hitched a ride on something and got brought into the mine. They had to fly the guy all the way to Columbus, OH to get the anti-venom because no one was stocking it during the Winter.

hansvm 3y ago

In the US that's still crazy exciting. Most of my hikes (at least, before I moved to the Bay), I'd rarely be within a 3h jog of the closest place a chopper could land, and that's assuming you have a satphone or something to actually contact the outside world. Plus, in a ton of states, driving is a privilege, not a right. I've lost my license a few times after the judge in question said I was justified but some bureaucrat in "public safety" or whatever didn't care about the life-threatening issues at hand and just yanked that privilege. Bureaucracy is hard to undo, and even if it weren't strictly a matter of improving my chance to live I'd much much much rather take a pill and a slow, safe route to the hospital than spend one more God-forsaken winter biking to work in -20F.

sandworm101 3y ago
Choppers don't need to land. Most of the time a rescue chopper would rather not. Winching you up to them is easier/safer than trying to land at an unprepared location. Even without a winch, they would "long line" you to the nearest road where there is room to land. https://youtu.be/WrllMSTm23c https://youtu.be/WrllMSTm23c https://youtu.be/nJZIDwMGHWc https://youtu.be/nJZIDwMGHWc
- hansvm 3y ago
  Interesting. I probably could have been a lot safer than anticipated.
- cf1241290841 3y ago
  Mountain rescue also has the impossibility to land. Here some HD footage from national geographic https://www.youtube.com/watch?v=Lk9QKRM_8Jo https://www.youtube.com/watch?v=Lk9QKRM_8Jo Notice the cut audio track. Giving these people the legal ability to give pain meds cant happen early enough. Mont Blanc helicopter rescue services also make some great documentaries every few years. The situation is even worse for a lot of snake bite victims, as you cant get lifted out of the rain forest.
  - dx034 3y ago

aaron695 3y ago

[dead]