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- W2500736086 abstract "Introduction and Objectives: Inhibitor development in nonsevere haemophilia A patients (FVIII:C, 2-40 IU/dL) has a heterogeneous clinical phenotype, ranging from irrelevant transient inhibitors to high titre neutralizing antibodies with severe bleeding complications. Data on inhibitor presentation are scarce and selected, favouring those with severe complications. The aim of current study was to describe the presenting symptoms of inhibitors in a large unselected cohort of nonsevere haemophilia patients. Materials and Methods: Clinical data were collected of 107 inhibitor patients derived from a source population of 2,709 nonsevere haemophilia A patients that were treated between 1980 and 2011 in 34 European and Australian centers (the INSIGHT consortium). Patients were subdivided according to age and calendar period at time of inhibitor development (10-year groups), aiming to search for age-related trends and trends over time. Results: Age at inhibitor detection varied widely between 1 and 85 years with a median age of 38 years (IQR, 15-61). Most inhibitors developed in the period of 2000-2010 (n = 64, 60%). Inhibitors developed after a median of 28 exposure days (IQR, 14-66), which was comparable between all age groups. Fifty-seven patients (56%) had high titre inhibitors (>5 BU/mL). About half of the high titre inhibitors developed in patients older than 40 years (n = 30, 53%) and 60% after the year 2000 (n = 34). In 13 (12%) inhibitor patients the inhibitor was detected during routine laboratory screening and no clinical signs of the inhibitor were present. More than half of the patients (n = 61) had an increased bleeding tendency at presentation with inhibitor. In 80 patients (80%) endogenous FVIII:C was decreased to below 5 IU/dL (including 33/44 patients with low titer inhibitors), of whom FVIII:C fell below ≤ 0.01 IU/mL in 49 patients (46%). Conclusion: Half of the patients with nonsevere haemophilia A and inhibitors developed high titre inhibitors; these were more common in the last decennium. More than half of the patients presented with bleeding complications and 46% had changed to a severe phenotype. These results stress the importance of close follow-up after exposure to therapeutic factor VIII concentrates in nonsevere haemophilia A patients." @default.
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- W2500736086 date "2014-04-25" @default.
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- W2500736086 doi "https://doi.org/10.1111/hae.12400" @default.
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