Batroxobin

Venom-Derived / Hemostatic

Also known as: Defibrase, Reptilase

Snake Venom PeptidesResearch phase: Approved (Asia)Regulatory: Approved in China, Japan for vascular conditions. Not FDA-approved.

Mechanism

Batroxobin is a thrombin-like enzyme from pit viper venom that selectively cleaves fibrinogen to reduce blood viscosity. It is approved in several Asian countries for stroke and vascular conditions.

Technical detail

Batroxobin is a serine protease (~36 kDa) from Bothrops atrox/moojeni venom. It selectively cleaves fibrinopeptide A from fibrinogen without activating Factor XIII or platelets, producing an unstable fibrin clot rapidly cleared by endogenous fibrinolysis. Net effect is defibrinogenation and reduced blood viscosity. Approved in China, Japan, and other Asian countries for ischemic stroke and peripheral vascular disease.

Evidence

  • Efficacy and safety of batroxobin in patients with acute ischemic stroke: A multicenter retrospective analysis.

    Liu S, Wang S, Zou Q, Pu Y, Li X, Hang Z, Cai Z, Wang C (2024) — CNS Neuroscience & Therapeutics — PMID: 39097914

    In a multicenter retrospective cohort of 492 patients with acute moderate-to-severe ischemic stroke within 24 hours and outside the thrombolysis window, 254 received standard therapy plus intravenous batroxobin while 238 received standard therapy alone. Batroxobin was associated with lower recurrent stroke risk (8.3% vs 17.2%; HR 0.433) and improved 90-120 day disability distribution without a statistically significant increase in moderate-to-severe bleeding events, supporting possible benefit that still needs prospective confirmation.

    emerging
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