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• W2108177522 endingPage "605" @default.
• W2108177522 startingPage "591" @default.
• W2108177522 abstract "Summary The revised UKHCDO factor (F) VIII/IX Inhibitor Guidelines (2000) are presented. A schema is proposed for inhibitor surveillance, which varies according to the severity of the haemophilia and the treatment type and regimen used. The methodological and pharmacokinetic approach to inhibitor surveillance in congenital haemophilia has been updated. Factor VIII/IX genotyping of patients is recommended to identify those at increased risk. All patients who develop an inhibitor should be considered for immune tolerance induction (ITI). The decision to attempt ITI for FIX inhibitors must be carefully weighed against the relatively high risk of reactions and the nephrotic syndrome and the relatively low response rate observed in this group. The start of ITI should be deferred until the inhibitor has declined below 10 Bethesda Units/ml, where possible. ITI should continue, even in resistant patients, where it is well tolerated and so long as there is a convincing downward trend in the inhibitor titre. The choice of treatment for bleeding in inhibitor patients is dictated by the severity of the bleed, the current inhibitor titre, the previous anamnestic response to FVIII/IX, the previous clinical response and the side‐effect profile of the agents available. We have reviewed novel dose‐regimens and modes of administration of FEIBA (factor VIII inhibitor bypassing activity) and recombinant activated FVII (rVIIa) and the extent to which these agents may be used for prophylaxis and surgery. Bleeding in acquired haemophilia is usually treated with FEIBA or rVIIa. Immunosuppressive therapy should be initiated at the time of diagnosis with Prednisolone 1 mg/kg/d ± cyclophosphamide. In the absence of a response to these agents within 6 weeks, second‐line therapy with Rituximab, Ciclosporin A, or other multiple‐modality regimens may be considered." @default.
• W2108177522 created "2016-06-24" @default.
• W2108177522 creator A5036282387 @default.
• W2108177522 creator A5038759748 @default.
• W2108177522 creator A5059264212 @default.
• W2108177522 creator A5063885274 @default.
• W2108177522 creator A5065311756 @default.
• W2108177522 date "2006-05-16" @default.
• W2108177522 modified "2023-10-16" @default.
• W2108177522 title "The diagnosis and management of factor VIII and IX inhibitors: a guideline from the United Kingdom Haemophilia Centre Doctors Organisation" @default.
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