Details

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Antithymocyte Immunoglobulin Injection is a lymphocyte selective immunosuppressant that belongs to an antithymocyte polyclonal antibodies group.

Antithymocyte globulin is widely used in organ and bone marrow transplants clinically.

It is used as both prophylaxis and treatment in organ transplants.

It is isolated from anti serum of horses, sheep and rabbits after their immunization by human lymphoid cells. Rabbit’s serum preparation is preferred due to less toxicity and higher potency.

Mechanism of action: it acts on activated T lymphocytes circulating in the blood and lymph leading to the death of lymphocytes and it also decreases the number of production of T lymphocytes from lymphoid follicles. This delays the hypersensitivity and immune response of the body.

It is available as Atgam and ATG in both International and Indian markets.

 

Uses

• Antithymocyte Immunoglobulin Injection is indicated in solid organ and bone marrow transplant to suppress the immunity response of the body against the transplant.
• Atgam is used to reverse hypersensitivity after organ transplant and as prophylaxis before transplants.
• Atgam is also given in aplastic anemia.

 

Dosage

• Antithymocyte Immunoglobulin Injection comes in a powder form in single use vials for intravenous injection.
• It must be administered by a healthcare professional experienced in immunosuppressive treatments.
• Premedication with corticosteroids, acetaminophen, and/or an antihistamine is required before administration.
• ATG must be infused slowly to minimize the complications due to rapid infusion.
• Dosages are determined by the doctor according to the medical condition, weight, response and side effects of the body to the drug.
• Dosages are also adjusted according to the dose related side effects like low blood cell count.
• In renal transplant recommended doses of ATG are 1.5 mg/kg daily for 4 to 7 days.

 

Side effects

• Fever
• nausea and vomiting
• Diarrhea
• Abdominal pain
• Headache
• Dizziness
• hypersensitivity reactions at the site of injection
• serum sickness
• Thrombocytopenia and leukopenia
• kidney damage
• Hypertension
• malignancies

 

Precautions

• Antithymocyte Immunoglobulin Injection is contraindicated in patients having chronic or acute infections and allergy to rabbit proteins.
• Patients must be monitored carefully to avoid any infection or reactivation of infection.
• Tell the doctor about ongoing medications,existing pre medical conditions and any allergy before starting the Atgam.
• Alcohol and smoking must be avoided while taking this drug.
• Always tell the doctor about pregnancy or future plan of pregnancy or breastfeeding.

ATG must be avoided in pregnancy and breastfeeding mothers, only used if benefits are more than the risk.