Horse v. Rabbit -- New Article

[KimO]

I thought the following article comparing the efficacy of Horse ATG to Rabbit was really interesting:

http://www.medpagetoday.com/MeetingC...matology/23799

[Lisa V]

Thanks for posting that, KimO. That's very good to know!

[Ryan Jay]

Didn't you guys get the sense that doctors always had a hunch that h-ATG was better?

I had it and it's working like a charm (knock on wood).

[Ryan Jay]

I just finished reading this. WOW!!! That's a huge difference!!!! Not even close.

Does that pretty much finish off ALG? Or will they keep it around as a back up for those patients who are non-responders to horse-ATG?

I just see labs full of rabbits going out of business. It would be ironic if some of us adopted those bunnies as pets.

Did they treat the refractory patients with Cyclosporine and h-ATG after they got the results?

[Neil Cuadra]

Until and unless there are research results to the contrary, this study seems to show that horse ATG should always be preferred over rabbit ATG when ATG is given as initial treatment for severe aplastic anemia. This study didn't cover patients with moderate aplastic anemia, who often "watch and wait" rather than undergo treatment.

They recommend that countries that use rabbit serum and haven't yet approved horse serum need to do so now.

[dmscott65]

My doctor told me about these findings on Monday at my follow-up appt. I have been doing very well. Hemoglobin hovering arond 8.9 -9.0. Platelets around 90. I am so grateful my Dr made the choice to h-ATG. It certainly seems to be working for me!

[JayVee718]

Neither horse nor rabbit atg worked for me. The only difference I noticed is that I tolerated horse atg way better than rabbit atg. I had rabbit atg 4 months after horse. I did not have any ill effects from horse atg but from rabbit atg I got hives, fevers and nausea. Unfortunately I went through all that torture for nothing because I still have extremely low blood counts.

[Candy S]

My daughter (dx at 15 1/2 in 2009) had the Rabbit ATG frist (3/2009).
After no response, we entered a clinical trial (for this very study you are discussing) at the National Institutes of Health (NIH). In October 2009, she has her second round IST with Horse ATG. By March 2010 she had a partial response...to date, she is still in the same place with a partial response.

I certainly hope there will be more improvement, but we wait...
If she does relapse, my choice would be to do another round of IST with Horse ATG (since she does not have a bone marrow donor).

[tytd]

KimO was right on target. The New England Journal of Medicine has just published in this week's edition the study by Scheinberg and all that suggests that horse ATG is the way to go for treatment of AA rather than rabbit ATG. Is horse ATG not available in the UK?

[Karenish]

Not great news for us in the UK who received rabbit in Feb of this year :0( - just entered my sixth month and still relying on regular transfusions. In the UK and Europe it has to undergo its own tests before we are allowed to use it!! otherwise here, patients are now routinely offered just cyclo!! Not fair is it really? So..... unless horse comes in quick, they will probably let me try rabbit again and then what..... poo poo I say - but I am staying positive and believe I will beat this blinking disease xxx

[triumphe64]

Karenish,

I know how you feel. When I first got ill, my doctor was getting out of date advice, but I didn't know any better. Then I found good doctors, and things changed completely. I would feel short changed when one of our best doctors, publishing in our best medical journal, would be almost ignored, especially for such a rare disease.