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Enroll for Rabies Updates

If you are interested in receiving the most current information about KEDRAB HRIG, proper rabies PEP, and RABV, as well as educational rabies resources, enroll now.

Formulary Monograph

Download the KEDRAB Formulary Monograph for detailed information about RABV, the efficacy and safety of KEDRAB, and why an HRIG, such as KEDRAB, is a crucial component of PEP.

RABIES VIRUS (RABV): STILL DEADLY AFTER 5000 YEARS2

Every year, about 40,000 people in the US receive rabies prevention, called post-exposure prophylaxis (PEP), because they had contact with a potentially rabid animal3

The Capacity of Rabies to Kill 99.9% of the People Infected4 Makes it One of the Deadliest Diseases in the World5

Death is inevitable following the onset of clinical symptoms,6 but 100% preventable if the rabies virus is treated promptly and properly.7

  • Once rabies enters the central nervous system, it is almost 100% fatal4
  • Globally, an estimated 59,000 people die every year of rabies, which is a staggering 160 people a day6
  • The rabies disease costs global economies $8.6 billion annually6

Treating Patients Exposed to RABV: a Limited Window of Opportunity After Exposure

There is a variable incubation period between exposure to RABV and the appearance of symptoms. This interval typically lasts 1 to 3 months. However, it may vary from 5 days to >2 years.8 KEDRAB should be given as soon as possible after exposure, but no later than seven days after the first dose of vaccine.9

Once symptoms appear, death is all but certain.6 Prompt and proper delivery of PEP can save the life of the person exposed to rabies.

WHAT CONSTITUTES PROPER POST-EXPOSURE PROPHYLAXIS (PEP)?

PEP Is Crucial in Preventing Rabies

The following 3 components of PEP are highly effective in preventing human rabies in exposed patients who have not been previously vaccinated against the virus.8
Proper PEP consists of the following:

WOUND CLEANSING

All PEP should begin with immediate and thorough cleansing of all bite wounds with soap and water, including a virucidal agent.9

ADMINISTRATION OF HRIG

An HRIG, such as KEDRAB, is administered to previously unvaccinated persons to provide immediate rabies virus-neutralizing antibodies (passive immunization) until the patient responds to the vaccine.1 KEDRAB should be given as soon as possible after exposure, but no later than seven days after the first dose of vaccine.9

VACCINATION AGAINST THE RABIES VIRUS

Rabies vaccine stimulates the patient’s immune system to produce virus-neutralizing antibodies (active immunization), which occurs approximately 7-10 days after initiation of the vaccine series.8

HOW KEDRAB HRIG WORKS IMMEDIATELY TO STOP RABV FROM SPREADING1

Adapted from Health and Disease Blog 2013.10

RABV Is Too Powerful for the Human Immune System to Fight11

Administration of KEDRAB HRIG, a biologic, thwarts the advance of RABV into the bite victim’s central nervous system long enough for the vaccine to boost the victim’s own natural immune response. The combination of HRIG and rabies vaccine is highly effective.8 In a 2016 animal study, 100% of animals exposed to rabies survived after administration of both HRIG and rabies vaccines. In this same study, 80% of animals survived when HRIG alone was administered, whereas 20% of the animals survived with vaccine alone.12

 

Because the incubation period for rabies in a given person cannot be readily predicted,13 delivering antiviral antibodies with an HRIG, such as KEDRAB, as soon as possible after exposure is recommended, as delays are potentially lethal.9

MANUFACTURING AND SAFETY

KEDRAB is a sterile, non-pyrogenic aqueous solution with a nominal potency of 150 IU/mL of anti-rabies immune globulin (human).9 It is prepared from human plasma from a pool of plasma collected from selected adult human donors who have been hyperimmunized with rabies vaccine and have developed high titers of anti-rabies antibody.9,14

 

Three Proprietary Viral Inactivation and Removal Steps

Three specific viral inactivation/removal steps are employed in the manufacture of KEDRAB:

1) Treatment with solvent/detergent (S/D) for inactivation of enveloped viral agents9

2) Heat treatment (pasteurization) for inactivation of both enveloped and non-enveloped viruses9

3) Nanofiltration using Planova 20N filters for the size-exclusion of both lipid-enveloped and non-enveloped viruses9,14

KEDRAB is derived from human plasma; therefore, the potential exists that KEDRAB administration may transmit infectious agents such as viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.9

 

Additional Purification Steps

Additional steps to the purification process for KEDRAB include euglobulin precipitation and ion exchange chromatography.14

Enroll for Rabies Updates

If you are interested in receiving the most current information about KEDRAB HRIG, proper PEP, and the rabies virus (RABV), as well as educational rabies resources, enroll now.