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Efficacy of succimer chelation of mercury at background exposures in toddlers: a randomized trial
Yang Cao1, Aimin Chen, Robert L Jones
1Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
Insights
Succimer treatment showed limited effectiveness in reducing blood mercury levels in children. While it prevented an age-related increase, it did not significantly lower existing mercury concentrations.
Area of Science:
- Environmental Health
- Pediatric Toxicology
- Chelation Therapy
Background:
- Succimer is a known chelating agent effective in reducing blood lead levels in children.
- Mercury exposure in children is a significant public health concern.
- Understanding the efficacy of succimer for mercury reduction is crucial for pediatric environmental health.
Purpose of the Study:
- To investigate the efficacy of succimer in reducing blood mercury concentrations in children.
- To determine if succimer's known lead-chelating properties extend to mercury reduction.
Main Methods:
- A randomized clinical trial involving children exposed to lead was utilized.
- Blood mercury levels were measured pre-treatment, post-treatment initiation, and after three courses of succimer or placebo.
- Bootstrap-based isotonic regression analyzed trends in mercury concentration differences between groups.
Main Results:
- The adjusted mean organic mercury concentration in the succimer group decreased from 99% to 82% relative to the placebo group after three treatment courses (P = .048).
- This reduction was primarily due to succimer preventing the typical age-related increase in mercury levels.
- The study found limited efficacy of succimer chelation for low-level organic mercury exposure in children.
Conclusions:
- Succimer demonstrates limited efficacy in reducing established low-level organic mercury burdens in children.
- The observed effect is mainly attributed to the prevention of mercury level increases over time.
- Further research may be needed to explore alternative or adjunct therapies for mercury chelation in pediatric populations.
Objective:
To examine whether succimer, a mercaptan compound known to reduce blood lead concentration in children, reduces blood mercury concentration.
Study Design:
We used samples from a randomized clinical trial of succimer chelation for lead-exposed children. We measured mercury levels in pre-treatment samples from 767 children. We also measured mercury levels in blood samples drawn 1 week after treatment began (n = 768) and in a 20% random sample of the children who received the maximum 3 courses of treatment (n = 67). A bootstrap-based isotonic regression method was used to compare the trend with time in the difference between the adjusted mean mercury concentrations in the succimer group and that in the placebo group.
Results:
The adjusted mean organic mercury concentration in the succimer group relative to the placebo group fell from 99% at baseline to 82% after 3 courses of treatment (P for trend = .048), but this resulted from the prevention of the age-related increase in the succimer group.
Conclusion:
Succimer chelation for low level organic mercury exposure in children has limited efficacy.
