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Varespladib, given on top of antivenom in a randomised trial in India and the USA, did not beat placebo. But it reached patients seven hours after the bite, and the authors say that timing may be the story.
A geostatistical re-estimate puts the global toll at 2.1 million envenomings and 274,000 deaths a year at minimum, with African incidence nearly three times South Asia's — against a short antivenom supply.
The experimental recombinant antivenom outperformed a plasma-derived product in mice and cut tissue necrosis. It has not been tested in a single human, and the paper does not address cost or manufacturing at scale.