Background:Zampilimab is an anti-transglutaminase 2 monoclonal antibody intended for the treatment of fibrosis such as Idiopathic Pulmonary Fibrosis IDF and Chronic Kidney Disease CAI. Transglutaminase 2 is a multi-functional enzyme that modifies proteins by catalyzing the formation of intermolecular isopeptide bonds between glutamine and lysine side-chains. It plays a role in several biological functions and is associated in the pathology of several diseases.3