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Prevention of bleeds in hemophilia patients with inhibitors: Emerging data and clinical direction
Author(s) -
Leissinger Cindy A.
Publication year - 2004
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20162
Subject(s) - medicine , incidence (geometry) , immune tolerance , clinical trial , immune system , disease , intensive care medicine , surgery , immunology , physics , optics
In patients with hemophilia, the development of high‐responding inhibitors to factor VIII prevents adequate replacement therapy and results in increased risk of serious bleeding episodes, poor control of joint bleeding, and progressive, debilitating joint disease. Immune tolerance therapy can eradicate inhibitors, but it is not uniformly successful. Emerging data suggest that prophylaxis using activated prothrombin complex concentrates may be effective and safe in reducing the incidence of joint bleeding during immune tolerance therapy and for patients in whom immune tolerance induction fails. However, only controlled clinical trials will ultimately demonstrate whether prophylaxis can prevent joint bleeding and damage, and improve quality of life in patients with inhibitors. Am. J. Hematol. 77:187–193, 2004. © 2004 Wiley‐Liss, Inc.