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Clinical issues in inhibitors

Astermark, Jan LU ; Santagostino, E. and Hoots, W. Keith (2010) In Haemophilia 16. p.54-60
Abstract
Anamestic inhibitors represent the major complication of haemophilia therapy now that clotting factor concentrates are virtually free of pathogen-transmission risk. Conventional clotting factor replacement is usually insufficient to prevent or treat bleeding in a haemophilia patient with a high responding inhibitor so that alternative treatment with bypassing agents is required. Despite their relative efficacy, their use does not achieve the same invariable haemostasis that patients without inhibitors do following treatment with factor concentrate replacement. This has led to the attempt to eradicate such inhibitors with immune tolerance induction. Success is not invariable, however, and many patients with long-term persistent high-titre... (More)
Anamestic inhibitors represent the major complication of haemophilia therapy now that clotting factor concentrates are virtually free of pathogen-transmission risk. Conventional clotting factor replacement is usually insufficient to prevent or treat bleeding in a haemophilia patient with a high responding inhibitor so that alternative treatment with bypassing agents is required. Despite their relative efficacy, their use does not achieve the same invariable haemostasis that patients without inhibitors do following treatment with factor concentrate replacement. This has led to the attempt to eradicate such inhibitors with immune tolerance induction. Success is not invariable, however, and many patients with long-term persistent high-titre inhibitors continue to experience great morbidity. Recently, this has given rise on a limited basis to attempts to use bypassing agents in prophylaxis regimens in an effort to alleviate this extreme morbidity. Each of these strategies is discussed in the context of their relative benefits and risks. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
factor VIII bypassing activity, immune tolerance induction, haemophilia A, Factor VIII inhibitors
in
Haemophilia
volume
16
pages
54 - 60
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000279076100009
  • pmid:20590857
  • scopus:77955026316
ISSN
1351-8216
DOI
10.1111/j.1365-2516.2010.02294.x
language
English
LU publication?
yes
id
96bc296d-13d7-4768-bb5e-73bf961db420 (old id 1630190)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20590857?dopt=Abstract
date added to LUP
2010-07-23 13:00:34
date last changed
2018-05-29 10:13:50
@article{96bc296d-13d7-4768-bb5e-73bf961db420,
  abstract     = {Anamestic inhibitors represent the major complication of haemophilia therapy now that clotting factor concentrates are virtually free of pathogen-transmission risk. Conventional clotting factor replacement is usually insufficient to prevent or treat bleeding in a haemophilia patient with a high responding inhibitor so that alternative treatment with bypassing agents is required. Despite their relative efficacy, their use does not achieve the same invariable haemostasis that patients without inhibitors do following treatment with factor concentrate replacement. This has led to the attempt to eradicate such inhibitors with immune tolerance induction. Success is not invariable, however, and many patients with long-term persistent high-titre inhibitors continue to experience great morbidity. Recently, this has given rise on a limited basis to attempts to use bypassing agents in prophylaxis regimens in an effort to alleviate this extreme morbidity. Each of these strategies is discussed in the context of their relative benefits and risks.},
  author       = {Astermark, Jan and Santagostino, E. and Hoots, W. Keith},
  issn         = {1351-8216},
  keyword      = {factor VIII bypassing activity,immune tolerance induction,haemophilia A,Factor VIII inhibitors},
  language     = {eng},
  pages        = {54--60},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {Haemophilia},
  title        = {Clinical issues in inhibitors},
  url          = {http://dx.doi.org/10.1111/j.1365-2516.2010.02294.x},
  volume       = {16},
  year         = {2010},
}