Some people who have
hemophilia A develop antibodies to the injected
clotting factor. The body thinks that
the replacement clotting factors don't belong in the body, so it creates
the antibodies, also called inhibitors, to get rid of them.
Inhibitors may make it harder to treat bleeding episodes because the
body's natural defense system (immune system) interferes with the
function of replacement clotting factors.
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people produce few inhibitors; others produce many.
How can I be treated?
If you have inhibitors, hemophilia treatment may require
specially engineered replacement clotting factors. Other treatment for clotting
factor inhibitors includes therapy to suppress the immune system
If you have a larger amount of inhibitors, you might be treated with:
Factor bypassing agents. These clotting factors are used
to skip the part of the clotting process that requires either clotting factor
VIII or IX. This treatment is unpredictable, and it is hard to determine the
correct dose. This treatment also slightly increases
your risk of having a heart attack or developing blood clots.
regimen that allows the body to get used to the clotting factor so that it
won't produce as many or any inhibitors. This is done by giving large amounts
of clotting factors daily over an extended period of time.
During the first part of the treatment, you will get a factor bypassing agent
along with the regular clotting factors to make sure that any injury will heal.
Once the body starts getting used to the clotting factor, the bypassing agent
is no longer needed.
If your body produces few inhibitors in reaction to clotting
factors, you may use the treatments above. You also may be treated
Large doses of the clotting factor, which can
overwhelm the inhibitors.
Factors taken from pig plasma (porcine
factors). People with a lot of inhibitors who do not respond to human clotting
factors often respond well to porcine factors.
A clotting factor that is
produced in a lab. Since it is man-made and does not come from human blood
products, there are no risks of getting viral infections when it is
If your body produces many inhibitors, you may be treated by
pumping your blood through a machine that removes or neutralizes the inhibitors
(plasmapheresis) to reduce or neutralize the inhibitors in the body. This
process only works temporarily and is used before a surgery or after a major
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Brian Leber, MDCM, FRCPC - Hematology
August 3, 2011
WebMD Medical Reference from Healthwise
August 03, 2011
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