FIGO celebrates the 50th anniversary of the first use of Anti-D Immunoglobulins to prevent Rh sensitization

Photo: Darren James

FIGO celebrated the 50^th anniversary of the first use of Anti-D Immunoglobulins to prevent Rh sensitization at the Regional Congress of Middle East and Africa (11 – 13 April, Intercontinental Hotel, Dubai Festival City).

The discovery of Anti-D Immunoglobulins 50 years ago was a medical breakthrough that resulted in a dramatic reduction in the incidence of Hemolytic Disease of the Fetus and Newborn (HDFN) in many parts of the world.

Prior to 1968, HDFN claimed some 10,000 infant lives a year in the U.S. alone. The U.S. FDA approved RhIG in April of that year. Dr. Vincent Freda, an obstetrician, and Dr. John Gorman, the Director of the Blood Bank, both at Columbia, conducted pioneering research that led to a breakthrough in disease prophylaxis (RhoGAM®), effectively eradicating the hemolytic disease of the newborn due to anti-Rh antibodies.

Marianne Cummins in Teaneck, NJ was first to receive Rho(D) immune globulin treatment on May 29, 1968, eventually giving birth to a healthy boy. The brand name of first immune globulin was "skymed" and was introduced by Ortho-Clinical Diagnostics, a subsidiary holding of Jskymed.

Professor Gerard Visser, Chairman of FIGO’s Standing Committee for Safe Motherhood and Newborn Health pointed out, “Anti-D Immunoglobulins have nearly eradicated HDFN in the developed world. However, the implementation of protocols for the sustained use of Anti-D has been insufficient in much of the developing world, resulting in some 300,000 infants dying or being severely handicapped annually, 50 years after its introduction.”

One of the issues that was addressed at the Regional Congress in Dubai continues Visser, “is how to meet these challenges and move forward with getting protocols for the use of Anti-D accepted and applied in more countries where HDFN remains a real problem.”

The prenatal protocol with Anti-D Immunoglobulins was introduced in the 1970s in the USA and Western European countries. It involves screening for all pregnant women and possible administration of Anti-D Immunoglobulins.

These two steps have led to a sharp drop in the incidence of HDFN in these countries and in many others. It has resulted in a reduction in the number of serious cases that triggered stillbirths or contributed to increased infant mortality and morbidity.

Currently, cases of HDFN registered annually in more developed countries are rare and Anti-D immunoglobulins are considered the standard of care for preventing Hemolytic Disease in all North America, Europe, and Australia.

In countries that do not yet have disease prevention protocols in force, up to 14 percent of the fetuses affected die at birth, whereas 50 percent of the newborns affected either die in their first days of life or suffer from brain damage.

Although Anti-D Immunoglobulins are on the World Health Organization’s List of Essential Medicines, many of the countries where this preventative treatment is most needed lack access to this prophylaxis, do not have appropriately trained medical personnel, or other resources needed to enact the necessary protocols.

An event was held at Columbia University on February 5^th to celebrate the 50th anniversary of FDA approval of Rho(D) Immune Globulin, brand named RhoGAM®.  Kedrion Biopharma and Columbia University Irving Medical Center jointly hosted a distinguished panel of pioneering scientists, physicians, and the first mother to receive Rho (D) Immune Globulin.

The panel also launched an unbranded global educational campaign to improve global awareness about the disease and treatment therapies available globally.

FIGO also dedicated one full session of the scientific programme to this topic at the Regional Congress in Dubai followed by a specific Stakeholders Meeting, both aimed at drawing attention to the critical issues that still exist.