TY - JOUR
T1 - The effect of a monoclonal antibody to tumor necrosis factor on survival from childhood cerebral malaria
AU - Van Hensbroek, Michaël Boele
AU - Palmer, Ayo
AU - Onyiorah, Emeka
AU - Schneider, Gisela
AU - Jaffar, Shabbar
AU - Dolan, Grainne
AU - Memming, Hannah
AU - Frenkel, Joost
AU - Enwere, Godwin
AU - Bennett, Steve
AU - Kwiatkowski, Dominic
AU - Greenwood, Brian
PY - 1996/1/1
Y1 - 1996/1/1
N2 - Tumor necrosis factor (TNF) is thought to play a key role in the pathogenesis of cerebral malaria. A double-blind, placebo-controlled trial of an anti-TNF monoclonal antibody (B-C7) comprised 610 Gambian children with cerebral malaria, with mortality and residual neurologic sequelae as primary study end points. Sixty (19.9%) of 302 children who received B-C7 died compared with 64 (20.8%) of 308 children who received placebo (adjusted odds ratio [OR], 0.90; 95% confidence interval [CI], 0.57-1.42). Residual neurologic sequelae were detected in 15 (6.8%) of 221 survivors from the B- C7 group and in 5 (2.2%) of 225 survivors of the placebo group (adjusted OR, 3.35; 95% CI, 1.0810.4). The monoclonal antibody used in this study did not improve survival in cerebral malaria and was associated with a significant increase in neurologic sequelae. A possible explanation of the latter observation is that the antibody acts to retain TNF within the circulation and thereby prolongs its effects on vascular endothelium.
AB - Tumor necrosis factor (TNF) is thought to play a key role in the pathogenesis of cerebral malaria. A double-blind, placebo-controlled trial of an anti-TNF monoclonal antibody (B-C7) comprised 610 Gambian children with cerebral malaria, with mortality and residual neurologic sequelae as primary study end points. Sixty (19.9%) of 302 children who received B-C7 died compared with 64 (20.8%) of 308 children who received placebo (adjusted odds ratio [OR], 0.90; 95% confidence interval [CI], 0.57-1.42). Residual neurologic sequelae were detected in 15 (6.8%) of 221 survivors from the B- C7 group and in 5 (2.2%) of 225 survivors of the placebo group (adjusted OR, 3.35; 95% CI, 1.0810.4). The monoclonal antibody used in this study did not improve survival in cerebral malaria and was associated with a significant increase in neurologic sequelae. A possible explanation of the latter observation is that the antibody acts to retain TNF within the circulation and thereby prolongs its effects on vascular endothelium.
UR - http://www.scopus.com/inward/record.url?scp=19244362897&partnerID=8YFLogxK
U2 - 10.1093/infdis/174.5.1091
DO - 10.1093/infdis/174.5.1091
M3 - Article
C2 - 8896514
AN - SCOPUS:19244362897
SN - 0022-1899
VL - 174
SP - 1091
EP - 1097
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 5
ER -