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Roledumab is a fully human recombinant IgG1 monoclonal antibody that targets the Rhesus D (RhD) antigen on red blood cells. It is designed for the prevention of fetomaternal alloimmunization in RhD-negative pregnant women carrying an RhD-positive fetus. Roledumab binds specifically to the RhD epitope (not present on certain rare variants such as DVI, DFR, DHAR and DHMI), leading to immune-mediated clearance of fetal RhD-positive red blood cells from maternal circulation. Compared to polyclonal anti-D immunoglobulin products traditionally used for this indication, roledumab demonstrates increased affinity for FcγRIIIa due to low Fc-fucosylation and enhanced antibody-dependent cellular cytotoxicity (ADCC) by natural killer cells. Its pharmacokinetic profile and safety are similar to those of polyclonal anti-D[1][3][5][6].
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