Antithymocyte immunoglobulin (rabbit)

Identification

Summary

Antithymocyte immunoglobulin (rabbit) is a purified form of rabbit anti-thymocyte antibodies used for immunosuppression in patients receiving kidney transplants.

Generic Name
Antithymocyte immunoglobulin (rabbit)
DrugBank Accession Number
DB00098
Background

Rabbit anti-thymocyte globulin. Thymoglobulin is a polyclonal antibody that suppresses certain types of immune cells responsible for acute organ rejection in transplant patients. Thymoglobulin is a mixture of antibodies intended to bind to various cell surface antigens. The most common mode of action of Thymoglobulin is via selective depletion of T-cells.

Type
Biotech
Groups
Approved
Biologic Classification
Protein Based Therapies
Polyclonal antibody (pAb)
Protein Structure
Db00098
Protein Chemical Formula
Not Available
Protein Average Weight
Not Available
Sequences
Not Available
Synonyms
  • Anti-human thymocyte immunoglobulin, rabbit
  • Anti-T-lymphocyte immune globulin, rabbit
  • Anti-thymocyte globulin (rabbit)
  • Anti-thymocyte globulin rabbit
  • Antithymocyte immunoglobulin
  • Lapine T-lymphocyte immune globulin
  • Rabbit anti-human thymocyte globulin
  • Rabbit anti-human thymocyte globulin (rATG)
  • Rabbit anti-human thymocyte immunoglobulin
  • Rabbit anti-thymocyte immunoglobulin
  • Rabbit antithymocyte globulin
  • Rabbit ATG
  • rATG
  • Thymoglobulin
  • Thymoglobuline

Pharmacology

Indication

For prevention of renal transplant rejection

Pharmacology
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Associated Conditions
Associated Therapies
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Antithymocyte Globulin (ATG) is a concentrated anti-human T-lymphocyte immunoglobulin preparation derived from rabbits after immunization with a T-lympoblast cell line. ATG is an immunosuppressive product for the prevention and treatment of acute rejection following organ transplantation. ATG reduces the host immune response against tissue transplants or organ allografts.

Mechanism of action

Binds to multiple, T-cell specific antigens leading to T-lymphocyte cell death via complement mediated cytotoxicity or apoptosis.

TargetActionsOrganism
UT-cell surface glycoprotein CD1a
inhibitor
Humans
AMajor histocompatibility complex class I-related gene protein
antagonist
Humans
AIntegrin alpha-LNot AvailableHumans
AT-lymphocyte activation antigen CD86
binder
Humans
ALow affinity immunoglobulin gamma Fc region receptor II-bNot AvailableHumans
AT-cell surface glycoprotein CD4Not AvailableHumans
AIntegrin beta-1Not AvailableHumans
AIntegrin alpha-VNot AvailableHumans
AIntegrin beta-3Not AvailableHumans
Absorption

T-cell depletion usually observed within 1 day after initiating therapy. Average 21.5 and 87 mcg/mL 4–8 hours post-infusion after first and last IV doses, respectively, when given for 7–11 days.

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism

Most likely removed by opsonization via the reticuloendothelial system when bound to T lymphocytes, or by human antimurine antibody production.

Route of elimination

Not Available

Half-life

2-3 days, may increase after multiple doses administration

Clearance

Not Available

Adverse Effects
Medicalerrors
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Toxicity

Not known whether ATG (rabbit) distributes into human milk; however, other immunoglobulins are distributed into human milk.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbataceptThe risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Abatacept.
AbciximabThe risk or severity of adverse effects can be increased when Abciximab is combined with Antithymocyte immunoglobulin (rabbit).
AdalimumabThe risk or severity of adverse effects can be increased when Adalimumab is combined with Antithymocyte immunoglobulin (rabbit).
Adenovirus type 7 vaccine liveThe risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Antithymocyte immunoglobulin (rabbit).
AldesleukinThe risk or severity of adverse effects can be increased when Aldesleukin is combined with Antithymocyte immunoglobulin (rabbit).
AlefaceptThe risk or severity of adverse effects can be increased when Alefacept is combined with Antithymocyte immunoglobulin (rabbit).
AlemtuzumabThe risk or severity of adverse effects can be increased when Alemtuzumab is combined with Antithymocyte immunoglobulin (rabbit).
AlirocumabThe risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Alirocumab.
AltretamineThe risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Altretamine.
AmsacrineThe risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Amsacrine.
Interactions
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Food Interactions
No interactions found.

Products

Products
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International/Other Brands
ATG-Fresenius (Fresenius SE) / ATG-Fresenius S (Fresenius SE)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
ThymoglobulinInjection, powder, lyophilized, for solution5 mg/1mLIntravenousGenzyme Corporation1998-12-30Not applicableUS flag
ThymoglobulinPowder, for solution25 mg / vialIntravenousSanofi Aventis2003-05-06Not applicableCanada flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
GRAFALON 5 ML IV INFUZYONLUK COZELTI KONSANTRESI ICEREN FLAKON, 1 ADETAntithymocyte immunoglobulin (rabbit) (5 ml)Injection, solutionIntravenousFRESENIUS MEDİKAL HİZMETLER A.Ş.2020-08-14Not applicableTurkey flag

Categories

ATC Codes
L04AA04 — Antithymocyte immunoglobulin (rabbit)
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
D7RD81HE4W
CAS number
308067-60-9

References

General References
Not Available
PubChem Substance
46506920
RxNav
107044
Therapeutic Targets Database
DAP001300
PharmGKB
PA164743704
Wikipedia
Anti-thymocyte_globulin
AHFS Codes
  • 92:00.00 — Miscellaneous Therapeutic Agents

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingPreventionCKD (Chronic Kidney Disease) Stage 5T / Diabetes Mellitus / Simultaneous Pancreas Kidney Transplantation1
4Active Not RecruitingTreatmentThymoglobulin Dose1
4CompletedNot AvailableEnd Stage Renal Disease (ESRD) / Living Donors1
4CompletedPreventionCytomegalovirus (CMV) Infection / Transplantation Infection1
4CompletedPreventionDisorder Related to Renal Transplantation1
4CompletedPreventionEnd Stage Renal Disease (ESRD)1
4CompletedPreventionKidney Transplant Rejection / Transplants and Implants1
4CompletedPreventionLeukemia, GVHD, ATG, Transplantation1
4CompletedPreventionTransplant; Failure, Kidney1
4CompletedPreventionTransplantation, Kidney1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
  • Genzyme Inc.
Dosage Forms
FormRouteStrength
Injection, solution, concentrateIntravenous
Injection, solutionIntravenous
Injection, powder, lyophilized, for solutionIntravenous5 mg/1mL
Powder, for solutionIntravenous25 mg / vial
Powder, for solutionIntravenous
Powder, for solutionParenteral
InjectionIntravenous
Injection, powder, lyophilized, for solutionParenteral
Injection, powder, lyophilized, for solutionIntravenous
Powder5 mg/mL
Prices
Unit descriptionCostUnit
Thymoglobulin 25 mg vial636.48USD vial
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Liquid
Experimental Properties
PropertyValueSource
melting point (°C)61 °C (FAB fragment), 71 °C (whole mAb)Vermeer, A.W.P. & Norde, W., Biophys. J. 78:394-404 (2000)

Targets

Drugtargets
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Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Lipopeptide binding
Specific Function
Antigen-presenting protein that binds self and non-self lipid and glycolipid antigens and presents them to T-cell receptors on natural killer T-cells.
Gene Name
CD1A
Uniprot ID
P06126
Uniprot Name
T-cell surface glycoprotein CD1a
Molecular Weight
37077.1 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [Article]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [Article]
  3. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Antagonist
General Function
Peptide antigen binding
Specific Function
Antigen-presenting molecule specialized in presenting microbial vitamin B metabolites. Involved in the development and expansion of a small population of T-cells expressing an invariant T-cell rece...
Gene Name
MR1
Uniprot ID
Q95460
Uniprot Name
Major histocompatibility complex class I-related gene protein
Molecular Weight
39365.76 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Metal ion binding
Specific Function
Integrin alpha-L/beta-2 is a receptor for ICAM1, ICAM2, ICAM3 and ICAM4. It is involved in a variety of immune phenomena including leukocyte-endothelial cell interaction, cytotoxic T-cell mediated ...
Gene Name
ITGAL
Uniprot ID
P20701
Uniprot Name
Integrin alpha-L
Molecular Weight
128768.495 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Binder
General Function
Virus receptor activity
Specific Function
Receptor involved in the costimulatory signal essential for T-lymphocyte proliferation and interleukin-2 production, by binding CD28 or CTLA-4. May play a critical role in the early events of T-cel...
Gene Name
CD86
Uniprot ID
P42081
Uniprot Name
T-lymphocyte activation antigen CD86
Molecular Weight
37681.97 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Not Available
Specific Function
Receptor for the Fc region of complexed or aggregated immunoglobulins gamma. Low affinity receptor. Involved in a variety of effector and regulatory functions such as phagocytosis of immune complex...
Gene Name
FCGR2B
Uniprot ID
P31994
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor II-b
Molecular Weight
34043.355 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Zinc ion binding
Specific Function
Accessory protein for MHC class-II antigen/T-cell receptor interaction. May regulate T-cell activation. Induces the aggregation of lipid rafts.(Microbial infection) Acts as a receptor for human imm...
Gene Name
CD4
Uniprot ID
P01730
Uniprot Name
T-cell surface glycoprotein CD4
Molecular Weight
51110.205 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Virus receptor activity
Specific Function
Integrins alpha-1/beta-1, alpha-2/beta-1, alpha-10/beta-1 and alpha-11/beta-1 are receptors for collagen. Integrins alpha-1/beta-1 and alpha-2/beta-2 recognize the proline-hydroxylated sequence G-F...
Gene Name
ITGB1
Uniprot ID
P05556
Uniprot Name
Integrin beta-1
Molecular Weight
88414.575 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Voltage-gated calcium channel activity
Specific Function
The alpha-V (ITGAV) integrins are receptors for vitronectin, cytotactin, fibronectin, fibrinogen, laminin, matrix metalloproteinase-2, osteopontin, osteomodulin, prothrombin, thrombospondin and vWF...
Gene Name
ITGAV
Uniprot ID
P06756
Uniprot Name
Integrin alpha-V
Molecular Weight
116036.855 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
General Function
Virus receptor activity
Specific Function
Integrin alpha-V/beta-3 (ITGAV:ITGB3) is a receptor for cytotactin, fibronectin, laminin, matrix metalloproteinase-2, osteopontin, osteomodulin, prothrombin, thrombospondin, vitronectin and von Wil...
Gene Name
ITGB3
Uniprot ID
P05106
Uniprot Name
Integrin beta-3
Molecular Weight
87056.975 Da
References
  1. Monti P, Allavena P, Di Carlo V, Piemonti L: Effects of anti-lymphocytes and anti-thymocytes globulin on human dendritic cells. Int Immunopharmacol. 2003 Feb;3(2):189-96. [Article]

Drug created on June 13, 2005 13:24 / Updated on May 15, 2021 12:14