Emerging treatments
Nipocalimab
Nipocalimab is a next-generation Fc receptor inhibitor, inhibiting immunoglobulin G (IgG) transport across the placenta (including the transfer of anti-red cell alloantibodies). A multicentre phase 2 study is ongoing to evaluate the safety, efficacy, pharmacokinetics, and pharmacodynamics of nipocalimab in pregnant women at high risk for early onset severe haemolytic disease of the fetus and newborn.[58] Nipocalimab has been granted rare paediatric disease designation and orphan drug designation by the US Food and Drug Administration for the prevention of haemolytic disease of the fetus and newborn.
Maternal therapy with plasmapheresis and/or intravenous immunoglobulin (IVIG)
Limited data, including isolated case reports, have supported the use of maternal plasmapheresis and/or IVIG in severe cases of maternal alloimmunisation in early gestation to reduce maternal antibody load and temporise, until a time in gestational age when intravascular fetal transfusion can be safely accomplished (i.e., >20 weeks). Limited reports of direct fetal treatment with IVIG suggest a possible role for this approach in selected patients.[59][60][61]
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