Can haemophilia with inhibitor be treated with different products within one immunotolerance treatment? Can we change the main product during the course of treatment? Do you have any experience with this? What are the pros and cons of such an approach?
My brother in law has an inhibitor. (against factor VIII). factor VIX was less effective.
He currently uses factor VII,with good results.Was effective for hip replacement.
As I understand it, immunotoleration can be done with several products. There is still alot of debate about the best stratergy and is very country specific. Acording to the WHR guidlines, changing products during a treatment is not recomended as this will change what the body sees interms of antigens. This area is discussed quite a lot at the ISTH and WHF conferences, checking the abstracts would be a good way of getting more information and perhaps people to contact.
Changing products is sometimes done. However, there is debate about many aspects of immune tolerance-- high vs. low dose, cost vs efficacy, duration, type of FVIII product, etc. There are definitely patients in which changing the type of product was thought to help reduce the inhibitor, but there is controversy. While treating patients with inhibitors with FVIII product
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