How I treat inhibitors in haemophilia.
The management of patients with inhibitors is the greatest challenge facing haemophilia health professionals. Immune tolerance induction (ITI) can be successful in eliminating the inhibitor in the majority of patients, provided it is started soon after the inhibitor develops and the titre of the inhibitor is <10 BU at commencement of ITI. Acute bleeding is treated using one of two bypassing agents, which exhibit similar efficacy and safety. Surgery in inhibitor patients is challenging and should only be carried out in experienced centres.
Department of Cardiovascular Science, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK. m.makris@sheffield.ac.uk
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Gringeri
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D'Oiron
D000208:Acute Disease; D019774:Blood Coagulation Factor Inhibitors / Q000097:blood*; D003029:Coagulants / Q000276:immunology / Q000627:therapeutic use*; D005169:Factor VIII / Q000276:immunology / Q000627:therapeutic use*; D006467:Hemophilia A / Q000188:drug therapy* / Q000276:immunology; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects* / Q000276:immunology; D013514:Surgical Procedures, Operative / Q000379:methods
D019774:Blood Coagulation Factor Inhibitors; D003029:Coagulants; D005169:Factor VIII