Info

Brand Name

Thymoglobulin®

Company

SangStat

Class

• Immunosuppressant gamma globulin, obtained by immunization of rabbits with human thymocytes

Mechanism of Action

• Antibodies of multiple specificities interact with lymphocyte surface antigens, depleting numbers of circulating T-lymphocytes and modulating T-lymphocyte activation, homing and cytotoxic processes

Indication

• Treatment of acute renal allograft rejection in combination with other immunosuppressants

Contraindication

• History of anaphylaxis or allergy to Thymoglobulin or rabbit proteins, or acute viral illness

Warnings

• Should be administered in facilities equipped and staffed with adequate laboratory and supportive medical resources

• Anaphylaxis has been reported

• Thrombocytopenia or neutropenia may result but are reversible with dose reduction or discontinuance

Special Precautions

• Risk of infections, leukopenia, thrombocytopenia, lymphoma, post-transplant lymphoproliferative disease or other malignancies

• Pregnancy Category C

• Leukopenia

• Pain/ abdominal pain

• Thrombocytopenia

• Dermatologic reactions

Drug Interaction

• None reported

Formulation

• 25 mg vial of lyophilized powder

Dosage

• 1.5 mg/kg/d for 7 to 14 days IV, diluted and infused through a 0.22 micron filter into a high flow vein

• First dose infused over a minimum of 6 hours, subsequent doses over a minimum of 4 hours

Editors' Notes:

Antithymocyte globulin (rabbit) is approved for the reversal of acute rejection. A doubleblind, randomized trial of thymoglobulin vs ATGAM® was conducted in 163 renal recipients with rejection. Thymoglobulin had a higher reversal rate than ATGAM® (88% vs 76%, p=0.027). Transplantation 66:29-37, July 15, 1998.

A recent study of high-risk renal transplants compared Thymoglobulin® induction with Simulect. The overall risk of rejection, delayed graft function and graft loss as statistically less frequent with Thymoglobulin®. (Brennan DC. A prospective, randomized, multi-center study of thymoglobulin compared to simulect for induction of immunosuppression: preliminary results. ©2002 American Transplant Congress.)

Azathioprine

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