Antithymocyte Globulin (Equine)
Class: Immunosuppressive Agents
- Antilymphocyte Immunoglobulins
- Immunosuppressive Agents
ATC Class: L04AA04
VA Class: IM600
Brands: Atgam
Warning
Should be used only by clinicians experienced in immunosuppressive therapy for the management of renal transplant or aplastic anemia patients.
Patients receiving antithymocyte globulin (equine) should be treated in facilities equipped and staffed with adequate laboratory and supportive medical resources.
Introduction
Lymphocyte immune globulin, antithymocyte globulin (equine) (ATG [equine]); equine-derived polyclonal antibody preparation; immunosuppressive agent.
Uses for Antithymocyte Globulin (Equine)
Renal Allotransplantation
Treatment of acute rejection of renal allografts, usually in conjunction with other immunosuppressive therapy.
Adjunctive ATG (equine) therapy successfully reverses most initial episodes of acute rejection in renal allograft recipients, including a high percentage of episodes severe enough to require hemodialysis.
Also may be effective for recurrent episodes of acute rejection and acute rejection episodes unresponsive to high-dose corticosteroid therapy.
ATG (equine) found to be less effective than antithymocyte globulin (rabbit) in reversing acute rejection episodes (76% compared with 88%) and preventing recurrent rejection episodes in renal transplant recipients.
Also used as induction therapy in conjunction with other immunosuppressive therapy to prevent or delay onset of renal allograft rejection. However, improved graft survival has not been consistently demonstrated.
Aplastic Anemia
Treatment of moderate to severe aplastic anemia in patients unsuitable for bone marrow transplantation.
When combined with conventional supportive therapy in patients with aplastic anemia, ATG (equine) may induce a partial or complete hematologic remission.
Safety and efficacy not fully evaluated in patients with aplastic anemia who are suitable candidates for bone marrow transplantation or in those with aplastic anemia secondary to neoplastic disease, storage disease, myelofibrosis, Fanconi's syndrome, or exposure to myelotoxic agents or radiation.
Graft-versus-host Disease
Treatment of corticosteroid-refractory and/or moderate to severe acute graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation or bone marrow transplantation†.
Also has been used for the prevention of GVHD following bone marrow transplantation†.
Other Organ Transplants
Has been used with some success to prevent and/or manage cardiac allograft rejection† in combination with other immunosuppressive medications.
Also has been used for induction therapy or treatment of rejection in lung transplantation† and combined heart-lung tr.
