title: US Guidelines for immune tolerance induction in patients with haemophilia a and inhibitors.
abstract: BACKGROUND
  The development of anti-factor VIII (FVIII) antibodies (inhibitors) is the most serious treatment-related complication in patients with hemophilia A, rendering standard replacement therapy ineffective, heightening the risk for uncontrollable bleeding and morbidity, decreasing quality of life, and increasing healthcare costs.
  
  
  OBJECTIVE
  Formulate evidence-based guidelines for optimizing immune tolerance induction (ITI) in patients with hemophilia A and inhibitors.
  
  
  METHODS
  Results from the International ITI study and other available evidence were used to develop guidelines for ITI.
  
  
  RESULTS
  Predictors of ITI success were identified and recommendations made for ITI with regard to candidates, timing, product, regimen, monitoring, defining success, concurrent immunomodulation, duration of treatment, and bleed management before and during ITI.
  
  
  CONCLUSIONS
  Evidence-based recommendations to guide treatment decisions may increase the likelihood of successful inhibitor eradication and the induction of FVIII tolerance in patients with hemophilia A who develop inhibitory antibodies.
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Valentino
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Aflac Cancer and Blood Disorders Center, Emory University/Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Kempton
authors.affiliation: Puget Sound Blood Center/University of Washington, Seattle, WA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Kruse-Jarres
authors.affiliation: University of New Mexico, Albuquerque, NM, USA.
authors.forename: P
authors.initials: P
authors.lastname: Mathew
authors.affiliation: Aflac Cancer and Blood Disorders Center, Emory University/Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Meeks
authors.affiliation: St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: U M
authors.initials: UM
authors.lastname: Reiss
mesh_terms: D015331:Cohort Studies; D005169:Factor VIII / Q000276:immunology*; D006287:Health Planning Guidelines; D006467:Hemophilia A / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D017410:Practice Guidelines as Topic; D012042:Registries; D014481:United States
chemical_list: D005169:Factor VIII
keywords: guidelines; haemophilia A; immune tolerance induction; inhibitors