Horse ATG More Effective Than Rabbit ATG for Acquired Aplastic Anemia

Six-month response rates were about twice as high with horse antithymocyte globulin as with rabbit antithymocyte globulin, resulting in a survival advantage at 3 years.

Immunosuppressive therapy for acquired aplastic anemia involves antithymocyte globulin (ATG) with cyclosporine. During the past decade, rabbit ATG has increasingly supplanted horse ATG because the rabbit ATG induces greater lymphopenia and, in tissue culture, stimulates the development of regulatory T-cells. However, until now, the two agents had not been directly compared. In this study, NIH researchers randomized 120 patients with acquired aplastic anemia to receive either rabbit ATG (3.5 mg/kg/day for 5 days) or horse ATG (40 mg/kg/day for 4 days), each together with cyclosporine.

During the first 3 months of treatment, three patients in the rabbit ATG group died of bleeding or infection, and one patient in the horse ATG group developed l…

Reviewing Author

David Green, MD, PhD

Disclosures

EquityNovartis

David Green, MD, PhD

Disclosures

EquityNovartis