Trinbelimab

In the last years high dose intravenous immunoglobulin (i.v.IG) has clearly modified the therapeutic approach toward autoimmune hemocytopenia. Their introduction has promoted the studies on the i.v.IG mechanisms of action: the hypothesis most widely accepted is the blockade of Fc-receptors in the reticuloendothelial system. It was hypothesized that low levels of anti-red blood cell antibodies contained in the i.v.IG preparations might be responsible for the Fc-receptor blockade. On this basis, anti-Rh(D) immunoglobulin has been successfully tested in Rh-positive patients with idiopathic thrombocytopenic purpura (ITP). The present paper describes the presumed mechanisms of action, clinical indications, side effects and cost of the anti-Rh(D) immunoglobulin. Until now, anti-Rh(D) has been chiefly employed in patients with ITP and human immunodeficiency virus-related ITP. However, at present, new clinical indications are emerging from studies in patients with autoimmune neutropenia, both using the intravenous and the intramuscular route. Anti-Rh(D) immunoglobulin has proved, in our and in other Authors' experience, a safe and easy to be administered treatment, at low cost and slightly lower in efficacy compared with i.v.IG.