ANTITHYMOCYTE IMMUNOGLOBULINS
Background and Date of Approval
Antithymocyte immunoglobulins is the active ingredient in this preparation. It is a purified and sterile form of gamma globulin, isolated from the hyperimmune plasma of horses immunized with human white blood cell components. It is used after kidney transplantation and other therapies to treat and delay organ rejection. Following solid organ transplantation, the body mounts an aggressive immune response because it recognises the transplanted organ's antigens as foreign. Therefore, treatment with immunosuppressive agents is necessary after organ transplant to prevent organ rejection. Antithymocyte immunoglobulin received initial FDA approval on 16 November 1998.
Uses
Antithymocyte immunoglobulins tablets are used for multiple purposes, including preventing organ rejection in organ transplantation, treating aplastic anemia, managing kidney rejection in renal allograft recipients, addressing autoimmune hemolytic anemia, and managing myasthenia gravis, a bone disorder.
How is it administered?
Antithymocyte immunoglobulins are typically administered intravenously injection in a hospital or clinical setting. Your healthcare provider will determine the specific dosage and infusion rate based on factors such as the condition being treated, your body weight, and your response to the medication.
Side Effects
Antithymocyte immunoglobulins are typically administered intravenously injection in a hospital or clinical setting. Your healthcare provider will determine the specific dosage and infusion rate based on factors such as the condition being treated, your body weight, and your response to the medication.
Warnings
Antithymocyte immunoglobulins have several important warnings associated with their use. These warnings include the risk of serious hypersensitivity reactions, such as anaphylaxis, which may require immediate medical attention. This medication can increase the risk of infections due to immunosuppression and may cause hepatotoxicity, drug-induced liver injury, and renal dysfunction. Infusion-related reactions, including fever and chills, may occur during administration. It may also lead to blood disorders, such as anemia and thrombocytopenia (decrease in white blood disease). Other warnings include the potential for neurological complications, malignancy risk, cytomegalovirus (CMV) reactivation, and considerations regarding use during pregnancy and breastfeeding.
Precautions
Precautions should also be taken to minimize the risk of CMV reactivation, and the potential risks and benefits of Antithymocyte immunoglobulins use during pregnancy and breastfeeding should be carefully evaluated. It is important to follow healthcare professionals' guidance and seek their individualized monitoring and management advice.
Word of Advice
Close infection surveillance is essential due to the increased risk associated with immunosuppression. Monitoring of liver function, kidney function, and blood counts is advised to detect potential hepatotoxicity, drug-induced liver injury, renal dysfunction, or blood disorders. Infusion-related reactions should be anticipated and managed appropriately. Pregnant and breastfeeding women should avoid use unless specifically indicated by their physician. Paediatric and geriatric patients require special consideration and dose adjustment. Psychological effects should be monitored during treatment. Regular consultation with your healthcare team is necessary to ensure safe and effective use of antithymocyte immunoglobulins.
References
1. S.E. Marshall, Immunological Factors in Disease, Davidsonâs Principles and Practice of Medicine, 22nd Edition, 2014, 71-96. 2. Genzyme Corporation, US Food and Drug Administration, [Revised on Apr 2017] [Accessed on 26th May 2023], https://www.fda.gov/media/74641/download
Frequently Asked Questions
How can I minimize the risk of infections while on Antithymocyte Immunoglobulins therapy?
It is important to follow proper hygiene practices to reduce the risk of infections, such as frequent handwashing and avoiding close contact with contagious individuals. Inform your healthcare provider about any signs of infection, such as fever, cough, or sore throat, for prompt evaluation and appropriate treatment.
Can Antithymocyte Immunoglobulins cause long-term kidney or liver damage?
While Antithymocyte Immunoglobulins can potentially cause kidney or liver dysfunction, the risk of long-term damage is generally low. However, regular kidney and liver function monitoring is important during the treatment to detect any early signs of impairment. Report any significant changes in urinary output or jaundice (yellowing of the skin or eyes) to your healthcare provider.
What steps can be taken to minimize infusion-related reactions?
Infusion-related reactions, such as fever and chills, can occur during Antithymocyte Immunoglobulins administration. Slowing the infusion rate, pre-medicating with antihistamines or corticosteroids, or using other supportive measures as your healthcare provider recommends can help minimize these reactions.
Is there an increased risk of developing malignancies with long-term Antithymocyte Immunoglobulins use?
Prolonged use of immunosuppressive agents, including Antithymocyte Immunoglobulins, may be associated with a slightly increased risk of developing certain malignancies. However, the overall risk is generally low. As your healthcare provider recommends, regular monitoring and screening for malignancies can help detect potential issues early.
Can Antithymocyte Immunoglobulins increase the risk of viral infections other than cytomegalovirus (CMV)?
While CMV reactivation is a known risk with Antithymocyte Immunoglobulins therapy, there may also be an increased susceptibility to other viral infections. It is important to discuss any specific concerns or symptoms with your healthcare provider, who can evaluate the risk and provide appropriate guidance.
Are any specific tests or monitoring required for patients on Antithymocyte Immunoglobulins therapy?
Monitoring kidney function, liver function, blood counts, and viral markers may be necessary during Antithymocyte Immunoglobulins treatment. Your healthcare provider will determine the appropriate monitoring schedule based on your condition and treatment plan.