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Rabbit Antithymocyte Globulin (Thymoglobulin®)

25 Years and New Frontiers in Solid Organ Transplantation and Haematology

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Abstract

The more than 25 years of clinical experience with rabbit antithymocyte globulin (rATG), specifically Thymoglobulin®, has transformed immuno-suppression in solid organ transplantation and haematology. The utility of rATG has evolved from the treatment of allograft rejection and graft-versus-host disease to the prevention of various complications that limit the success of solid organ and stem cell transplantation. Today, rATG is being successfully incorporated into novel therapeutic regimens that seek to reduce overall toxicity and improve long-term outcomes. Clinical trials have demonstrated the efficacy and safety of rATG in recipients of various types of solid organ allografts, recipients of allogeneic stem cell transplants who are conditioned with both conventional and nonconventional regimens, and patients with aplastic anaemia. Over time, clinicians have learnt how to better balance the benefits and risks associated with rATG. Advances in the understanding of the multifaceted mechanism of action will guide research into new therapeutic areas and future applications.

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Acknowledgements

The authors would like to thank Dr Kathleen Romaszko, of MedLogix Communications, for editorial support. Dr Romaszko assisted the authors with searching the medical literature, procuring references and preparing the manuscript. The authors reviewed and approved all supporting references cited and provided critical revision of this manuscript. This paper was supported by Genzyme Corporation; no honoraria were provided to the authors for their participation. Dr Gaber has served on an advisory board for Genzyme; Dr Russell has received honoraria and has a study grant pending from Genzyme; and Dr Mohty has acted as a consultant for Genzyme, Amgen and Janssen, received honoraria from Genzyme, Amgen, Janssen, Celgene and Pierre Fabre, and received grants from Genzyme and Pierre Fabre.

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Authors and Affiliations

  1. Department of Surgery, The Methodist Hospital, 6550 Fannin Street, SM1661, Houston, Texas, 77030, USA

    A. Osama Gaber

  2. Department of Transplantation, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Anthony P. Monaco

  3. Department of Medicine and Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada

    James A. Russell

  4. Service de Néphrologie et d’Immunologie Clinique, CHU de Tours, Tours, France

    Yvon Lebranchu

  5. Service d’Hématologie Clinique, CHU Hôtel Dieu, Université de Nantes, Nantes, France

    Mohamad Mohty

Authors
  1. A. Osama Gaber
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  2. Anthony P. Monaco
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  3. James A. Russell
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  4. Yvon Lebranchu
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  5. Mohamad Mohty
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Corresponding author

Correspondence to A. Osama Gaber.

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Gaber, A.O., Monaco, A.P., Russell, J.A. et al. Rabbit Antithymocyte Globulin (Thymoglobulin®). Drugs 70, 691–732 (2010). https://doi.org/10.2165/11315940-000000000-00000

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