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Hemophilia: Immune tolerance induction

Starting Immune Tolerance Induction (to get rid of inhibitors)

Starting Immune Tolerance Induction (to get rid of inhibitors)

To know more, see the PDF version of this Decision Box by clicking here.

  • What is Immune Tolerance Induction?Learn more

    Some people with hemophilia develop antibodies - called inhibitors - against clotting factor they received as treatment because their body wrongly interprets the treatment as dangerous. Immune Tolerance Induction (ITI) aims to get rid of inhibitors by teaching the body to accept the clotting factor.

  • Who should consider this treatment?Learn more

    Persons with hemophilia A or B who have developed an inhibitor to factor concentrate. Having an inhibitor makes treating bleeding events difficult and may cause joint disease and other complications.

  • What is usually involved?Learn more

    Regular injections (directly into the vein OR through a venous access device that is surgically put in place) of clotting factor, to help make the body used to factor products and stop making inhibitors.

  • What are the two decisions and their options?Learn more

    (see the printable version for more details)

    (1) When to start ITI?
    • Delayed: Waiting to see if inhibitor level will decrease on its own
    • Early: Immediately after detecting inhibitor, without waiting to see what will happen
    (2) What regimen of ITI?
    • High dose with immunosuppressant
    • High dose
    • Low dose

Version 1