Current estimates show that only 1% of people,who should be treated with Rabies Immuno Globulin(RIG), actually receive it. Human RIG(HRIG) due to its high cost and poor availability, whereas Equine RIG (eRIG, manufactured in horses) though less scarce and much cheaper, has significant production problems. The use of eRIG has also been associated with very rare, but severe cases of anaphylactic shock. Because of these concerns, alternatives to HRIG and eRIG have been in development for decades now.
The first monoclonal antibody product developed to replace the rabies immunoglobulin (RIG) is now available across India. Rabishield is a human monoclonal antibody manufactured by recombinant DNA technology. It has passed clinical trials in India showing that it is as effective as human RIG. According to the manufacturer, the product offers passive immunization against all rabies serotypes found in India. It is described as more potent, requiring a lower dose (3.33 IU/kg body weight- available as Rabishield-100 IU per 2.5 ml vial) than current rabies immune globulins (20 or 40 IU/kg of body weight for HRIG or ERIG, respectively). There is no maximum ceiling dose for monoclonal antibody.
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