The effect of a monoclonal antibody to tumor necrosis factor on survival from childhood cerebral malaria

MB van Hensbroek, A Palmer… - Journal of infectious …, 1996 - academic.oup.com
MB van Hensbroek, A Palmer, E Onyiorah, G Schneider, S Jaffar, G Dolan, H Memming…
Journal of infectious diseases, 1996academic.oup.com
Tumor necrosis factor (TNF) is thought to playa 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 …
Abstract
Tumor necrosis factor (TNF) is thought to playa 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, 1.08–10.4). 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.
Oxford University Press