Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax

The Centers for Disease Control and Prevention recommend adjunctive antitoxins when systemic anthrax is suspected. Obiltoxaximab, a monoclonal antibody against protective antigen (PA), is approved for treatment of inhalational anthrax in combination with antibiotics and for prophylaxis when alternat...

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Main Authors: Yamamoto, Brent J., Shadiack, Annette M., Carpenter, Sarah, Sanford, Daniel, Henning, Lisa N., Gonzales, Nestor, O'Connor, Edward, Casey, Leslie S., Serbina, Natalya V.
Format: Online
Language:English
Published: American Society for Microbiology 2016
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038297/
id pubmed-5038297
recordtype oai_dc
spelling pubmed-50382972016-10-13 Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax Yamamoto, Brent J. Shadiack, Annette M. Carpenter, Sarah Sanford, Daniel Henning, Lisa N. Gonzales, Nestor O'Connor, Edward Casey, Leslie S. Serbina, Natalya V. Clinical Therapeutics The Centers for Disease Control and Prevention recommend adjunctive antitoxins when systemic anthrax is suspected. Obiltoxaximab, a monoclonal antibody against protective antigen (PA), is approved for treatment of inhalational anthrax in combination with antibiotics and for prophylaxis when alternative therapies are not available. The impact of toxin neutralization with obiltoxaximab during pre- and postexposure prophylaxis was explored, and efficacy results that supported the prophylaxis indication are presented here. New Zealand White rabbits and cynomolgus macaques received obiltoxaximab as a single intramuscular or intravenous dose of 2 to 16 mg/kg of body weight at various times relative to Bacillus anthracis aerosol spore challenge. The primary endpoint was survival, and effect of treatment timing was explored. In rabbits, obiltoxaximab administration 9 h postchallenge singly or combined with a 5-day levofloxacin regimen protected 89% to 100% of animals compared to 33% with levofloxacin monotherapy. In cynomolgus macaques, a single intramuscular dose of 16 mg/kg obiltoxaximab led to 100% survival when given 1 to 3 days preexposure and 83% to 100% survival when given 18 to 24 h postexposure and prior to systemic bacteremia onset. Obiltoxaximab administration after bacteremia onset resulted in lower (25% to 50%) survival rates reflective of treatment setting. Prophylactic administration of obiltoxaximab before spore challenge or to spore-challenged animals before systemic bacterial dissemination is efficacious in promoting survival, ameliorating toxemia, and inhibiting bacterial spread to the periphery. American Society for Microbiology 2016-09-23 /pmc/articles/PMC5038297/ /pubmed/27431219 http://dx.doi.org/10.1128/AAC.01102-16 Text en Copyright © 2016 Yamamoto et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (http://creativecommons.org/licenses/by/4.0/) .
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Yamamoto, Brent J.
Shadiack, Annette M.
Carpenter, Sarah
Sanford, Daniel
Henning, Lisa N.
Gonzales, Nestor
O'Connor, Edward
Casey, Leslie S.
Serbina, Natalya V.
spellingShingle Yamamoto, Brent J.
Shadiack, Annette M.
Carpenter, Sarah
Sanford, Daniel
Henning, Lisa N.
Gonzales, Nestor
O'Connor, Edward
Casey, Leslie S.
Serbina, Natalya V.
Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
author_facet Yamamoto, Brent J.
Shadiack, Annette M.
Carpenter, Sarah
Sanford, Daniel
Henning, Lisa N.
Gonzales, Nestor
O'Connor, Edward
Casey, Leslie S.
Serbina, Natalya V.
author_sort Yamamoto, Brent J.
title Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
title_short Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
title_full Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
title_fullStr Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
title_full_unstemmed Obiltoxaximab Prevents Disseminated Bacillus anthracis Infection and Improves Survival during Pre- and Postexposure Prophylaxis in Animal Models of Inhalational Anthrax
title_sort obiltoxaximab prevents disseminated bacillus anthracis infection and improves survival during pre- and postexposure prophylaxis in animal models of inhalational anthrax
description The Centers for Disease Control and Prevention recommend adjunctive antitoxins when systemic anthrax is suspected. Obiltoxaximab, a monoclonal antibody against protective antigen (PA), is approved for treatment of inhalational anthrax in combination with antibiotics and for prophylaxis when alternative therapies are not available. The impact of toxin neutralization with obiltoxaximab during pre- and postexposure prophylaxis was explored, and efficacy results that supported the prophylaxis indication are presented here. New Zealand White rabbits and cynomolgus macaques received obiltoxaximab as a single intramuscular or intravenous dose of 2 to 16 mg/kg of body weight at various times relative to Bacillus anthracis aerosol spore challenge. The primary endpoint was survival, and effect of treatment timing was explored. In rabbits, obiltoxaximab administration 9 h postchallenge singly or combined with a 5-day levofloxacin regimen protected 89% to 100% of animals compared to 33% with levofloxacin monotherapy. In cynomolgus macaques, a single intramuscular dose of 16 mg/kg obiltoxaximab led to 100% survival when given 1 to 3 days preexposure and 83% to 100% survival when given 18 to 24 h postexposure and prior to systemic bacteremia onset. Obiltoxaximab administration after bacteremia onset resulted in lower (25% to 50%) survival rates reflective of treatment setting. Prophylactic administration of obiltoxaximab before spore challenge or to spore-challenged animals before systemic bacterial dissemination is efficacious in promoting survival, ameliorating toxemia, and inhibiting bacterial spread to the periphery.
publisher American Society for Microbiology
publishDate 2016
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038297/
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