The importance of inhibitor eradication in clinically complicated hemophilia A patients

Johannes Oldenburg, Guy Young, Elena Santagostino, Carmen Escuriola Ettingshausen

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction: Inhibitors against factor VIII (FVIII), which develop in around 20–30% of patients with severe hemophilia A, represent a significant complication of on-demand or prophylactic FVIII therapy. Currently, the main treatment option for inhibitor patients is eradication using immune tolerance induction (ITI) therapy. Areas covered: This article reviews inhibitor eradication in clinically complicated hemophilia A patients. The benefits and disadvantages of ITI therapy are discussed, with reference to the new nonfactor replacement agents such as emicizumab, which are becoming available. Expert commentary: At present, ITI therapy is the method of choice for all inhibitor patients, but as alternative treatment options become increasingly available, this may change in the future. Despite the development of nonfactor replacement agents, ITI therapy is likely to maintain a key role in the management of inhibitor patients, although changes in ITI therapy regimens including the timing of ITI initiation, the dosing regimen, the management of thrombotic risk or safety, laboratory assessment of ITI outcomes, and maintenance treatment after ITI success, may be necessary.

Original languageEnglish
Pages (from-to)857-862
Number of pages6
JournalExpert Review of Hematology
Volume11
Issue number11
DOIs
Publication statusPublished - Nov 2 2018

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Immune Tolerance
Hemophilia A
Factor VIII
Therapeutics
Safety Management
Risk Management

Keywords

  • Factor VIII
  • hemophilia A
  • immune tolerance induction
  • inhibitors

ASJC Scopus subject areas

  • Hematology

Cite this

The importance of inhibitor eradication in clinically complicated hemophilia A patients. / Oldenburg, Johannes; Young, Guy; Santagostino, Elena; Escuriola Ettingshausen, Carmen.

In: Expert Review of Hematology, Vol. 11, No. 11, 02.11.2018, p. 857-862.

Research output: Contribution to journalReview article

Oldenburg, Johannes ; Young, Guy ; Santagostino, Elena ; Escuriola Ettingshausen, Carmen. / The importance of inhibitor eradication in clinically complicated hemophilia A patients. In: Expert Review of Hematology. 2018 ; Vol. 11, No. 11. pp. 857-862.
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