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Designer Image 40 Overview
Hemophilia
Inhibitors
Joint Health
Managing Joint Pain
Joint Damage
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What are Inhibitors
Risk of Developing an Inhibitor
Tests for Types of Inhibitors
Treatment for Hemophilia With a Inhibitors
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TREATMENT FOR HEMOPHILIA WITH INHIBITORS
Inhibitors make hemophilia more challenging. The ultimate goal for treatment is to get rid of the inhibitors.

People with low-responding inhibitors have a difficult time with replacement therapy, but bleeding can usually be stopped by increasing the dose of factor VIII or factor IX.38 For people with high-responding inhibitors, alternative treatments may be needed.38 These include:
  • Bypassing products – Bypassing products, also called bypassing agents, are used to treat bleeds in people with inhibitors. The agent bypasses the need for factor VIII or factor IX and allows clotting.
  • Immune tolerance therapy (ITT) – ITT, also called ITI (immune tolerance induction), is used to try to get rid of the inhibitors. With ITT, replacement doses of factor VIII or factor IX are taken every day over a long period of time. When it works, ITT can stop the body from making inhibitors. ITT has shown to be effective in 60% to 80% of cases. ITT can take from several months to several years to complete. During ITT, it’s often necessary to use a bypassing agent to control bleeding episodes.39
  • Immunadsorption40, 41 (IA) – IA or extracorporeal IA, is a process where the blood is taken out of the body. Once removed, the blood is separated using a complex procedure to remove the harmful products.  The safe and clean blood is returned to the body.  It is similar, but not equivalent to, plasmapheresis.
  • Plasmapheresis38, 42 – Plasmapheresis is a process where blood is removed from the body and then separated by a machine to remove the harmful parts. After separation, the clean and safe blood cells are returned to the person undergoing treatment, while the part that contains the antibodies is treated and then returned to the patient with the administration of factor VIII concentrates and fresh frozen plasma. This may be used in combination with ITT.

*Procedures mentioned are not recommended for acute bleeding episodes. People with clotting disorders may not be suitable candidates for plasmapheresis. Plasmapheresis and IA are not routine procedures and are best suited for use as a preventative and protective way to remove antibodies prior to an anticipated procedure.38

To learn more about hemophilia A or B with inhibitors and its treatment, you can request information pamphlets or visit some of the hemophilia websites in the Resources Section.
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