AZALEA: Nipocalimab in Hemolytic Disease of the Fetus and Newborn

  • Research type

    Research Study

  • Full title

    A Phase 3 Randomized, Placebo-Controlled, Double-Blind, Multicenter Study to Evaluate the Efficacy and Safety of Nipocalimab in Pregnancies at Risk for Severe Hemolytic Disease of the Fetus and Newborn (HDFN).

  • IRAS ID

    1008016

  • Contact name

    David Wright

  • Contact email

    GCOUKSubmissions@its.jnj.com

  • Sponsor organisation

    Janssen-Cilag International N.V.

  • Eudract number

    2022-502629-16

  • ISRCTN Number

    ISRCTN12057804

  • Clinicaltrials.gov Identifier

    NCT05912517

  • Research summary

    Hemolytic disease of the newborn and fetus (HDFN) is a rare and potentially life-threatening blood disorder in newborn babies and fetuses that occurs when the blood types of the pregnant individual and fetus/baby are incompatible, thus resulting in fast breakdown of red blood cells (RBCs) of the fetus/baby. This may lead to anemia (low hemoglobin levels), jaundice (yellow discoloration of the skin because of the high levels of the chemical, bilirubin in blood) and other related complications.
    Currently, severe HDFN is most commonly treated by injecting donor red blood cells into the fetus, a procedure called intrauterine transfusion. Nipocalimab, the study drug in this trial, is a protein that targets and binds to a specific molecule called FcRn (neonatal fragment crystallizable receptor). These receptors are found throughout the body and also in the placenta.
    In pregnant individuals at risk for severe HDFN, nipocalimab aims to decrease the level of IgG (immunoglobulin G) antibodies* targeting fetal RBCs by binding to the FcRn receptor thereby decreasing IgG levels in the pregnant individual pregnant individuals IgG antibodies to the fetus across the placenta. Nipocalimab may be a less invasive option for managing severe HDFN. (*one type of protein that protects the body from infections caused by bacteria, viruses, and other foreign substances in the blood.)
    The purpose of the study is to assess the safety and effectiveness of nipocalimab compared to placebo (a drug like substance that has no therapeutic effect) in the treatment of pregnant individuals at risk of developing severe HDFN. Not everyone in the study will receive nipocalimab. For every two participants who receive nipocalimab, one participant receives placebo. This is a double-blind study, which means that the participant and the study doctor/team will not know whether if you are receiving nipocalimab or placebo.

  • REC name

    West Midlands - Edgbaston Research Ethics Committee

  • REC reference

    23/WM/0223

  • Date of REC Opinion

    23 Nov 2023

  • REC opinion

    Further Information Favourable Opinion