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Application of current knowledge to the management of bleeding events during immune tolerance induction
Author(s) -
DI PAOLA J.,
ALEDORT L.,
BRITTON H.,
CARCAO M.,
GRABOWSKI E.,
HUTTER J.,
JOURNEYCAKE J.,
KEMPTON C.,
LEISSINGER C.
Publication year - 2006
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2006.01343.x
Subject(s) - medicine , interim , intensive care medicine , haemophilia , perioperative , adverse effect , clinical trial , immune tolerance , medline , immune system , pediatrics , immunology , surgery , archaeology , political science , law , history
Summary. The development of inhibitors to factor VIII is the most serious adverse event associated with the treatment of haemophilia A, predisposing patients to uncontrollable haemorrhage, disability and premature death. Eradication of inhibitors via immune tolerance induction (ITI) is effective in the majority of patients, but may require months to years to achieve success. In the interim, the treatment and prevention of acute bleeding episodes are primary foci of care. Regrettably, there is a paucity of information regarding management of bleeding episodes in inhibitor patients undergoing tolerization. Until specific data from ongoing clinical trials are available to provide more guidance in this patient group, it is reasonable and useful to rely on the broader base of medical literature pertaining to patients not being tolerized to deduce strategies for controlling acute and perioperative bleeding episodes in inhibitor patients during ITI.