Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 27, Issue 8, Pages 655-662Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0030-1249762
Keywords
Digoxin immune Fab; endogenous digitalis-like factors; preeclampsia; sodium pump
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Funding
- Protherics
- Glenveigh Research
- GlaxoSmithKline
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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.
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