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Innovative Medicines & Omics Progress in antivenom therapy

venoms from particular species or genera, their efficacy and essential medicines, which would evaluate the safety,
is restricted to envenomations by those specific snakes or efficacy, and quality of antivenoms to guide procurement
closely related taxa. Given that accurate snake identification decisions by national health agencies.
is often impossible in emergency scenarios—particularly In addition to WHO efforts, academic research
when the bite is unwitnessed or the snake escapes—there institutions, non-governmental organizations (NGOs),
is a high risk of therapeutic mismatch. This is especially and public-private partnerships have begun investing in
problematic in regions with high biodiversity or where alternative therapeutic approaches, including recombinant
multiple medically significant species co-occur. antivenoms, monoclonal antibodies, and small-molecule
Another serious limitation is the immunogenicity of inhibitors. These emerging technologies hold the promise
heterologous antibodies. Since these products are derived of safer, more cost-effective, and broadly neutralizing
from non-human animals, their administration can antivenoms, but their widespread clinical adoption
provoke adverse immune responses ranging from mild remains several years away.
urticaria and fever to severe anaphylaxis and delayed In conclusion, while modern antivenoms have saved
serum sickness. This immunologic burden not only countless lives and represent a significant achievement in
complicates clinical management but also deters some medical science, their present formulation and distribution
patients from seeking care due to fear or previous negative remain suboptimal. A multifaceted approach—spanning
experiences. Although premedication with antihistamines scientific innovation, policy reform, and health systems
and corticosteroids is common practice, these measures strengthening—is required to overcome these barriers
are not always effective in mitigating severe reactions. and ensure that antivenom therapy becomes a universally
Furthermore, logistical and economic barriers play a accessible and effective intervention.
substantial role in restricting access to antivenom therapy
in the regions where it is most urgently needed. Antivenoms 4. Innovations in antivenom therapy
are biologic products that require strict cold-chain storage Innovations in antivenom therapy over the past two
conditions (typically 2–8°C) to maintain their stability decades have sought to overcome the persistent limitations
and efficacy. Such requirements are difficult to meet in of traditional animal-derived antivenoms and to develop
many rural or resource-poor settings, where electricity novel approaches that are safer, more effective, and more
and refrigeration may be intermittent or nonexistent. accessible to snakebite victims in endemic regions. While
The production process itself is also expensive and time- present manufacturing processes remain largely rooted in
consuming, involving extensive quality control measures the historical principles established by Calmette and Vital
to ensure sterility, potency, and freedom from transmissible Brazil, emerging biotechnological advancements are now
agents. These costs are often passed on to healthcare reshaping the landscape of envenomation treatment.
systems or patients, rendering the antivenom unaffordable One of the most promising avenues of innovation
in many low-income countries. As a result, supply-demand involves the development of recombinant and monoclonal
mismatches and commercial disincentives have led to the antibody-based therapies. 10 Unlike conventional
withdrawal of manufacturers from unprofitable markets, polyclonal antivenoms, which contain a complex and
exacerbating global shortages.
variable mixture of antibodies harvested from immunized
In response to these systemic challenges, the WHO has animals, recombinant antivenoms can be engineered
intensified its efforts to coordinate a global strategy for to contain specific human or humanized monoclonal
snakebite envenomation, which it formally designated as a antibodies that target the most toxic and medically relevant
neglected tropical disease in 2017. A landmark initiative— components of snake venom, such as metalloproteinases,
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“Snakebite Envenoming: A Strategy for Prevention and phospholipase A (PLA ), and three-finger toxins. These
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Control”—was published by the WHO in 2019. This monoclonal antibodies can be produced in controlled
strategy outlines ambitious goals to reduce snakebite deaths cell culture systems, eliminating the reliance on animal
and disabilities by 50% by the year 2030. It emphasizes immunization and addressing key issues related to
strengthening antivenom manufacturing capabilities in batch variability, immunogenicity, and contamination.
endemic countries, developing standardized preclinical Furthermore, because they can be precisely designed to
testing protocols, and fostering international partnerships recognize conserved toxin epitopes across different snake
to subsidize and regulate the antivenom market. One of species, recombinant antivenoms hold the potential for
the key components of this initiative is the creation of a broader cross-neutralization, thereby mitigating the
prequalification program, akin to those used for vaccines clinical challenges posed by species misidentification.

Volume 2 Issue 3 (2025) 16 doi: 10.36922/IMO025240026