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  • Title: Hemophilia treatment. Immune tolerance induction: prospective clinical trials.
    Author: Hay CR.
    Journal: Haematologica; 2000 Oct; 85(10 Suppl):52-5; discussion 55-6. PubMed ID: 11187872.
    Abstract:
    Successful immune tolerance induction (ITI) relates significantly to the starting inhibitor titer but not the peak historical inhibitor titer. Below a starting titer of 10 BU/mL success appears to be unrelated to the dose of factor VIII (FVIII) used for ITI. Above this starting titer, larger doses of FVIII may be associated with a better outcome from ITI. Opinion on the importance of the dose of FVIII used for ITI is polarized and there is no agreement on the optimal regimen for ITI. A prospective randomized clinical trial is proposed in which patients will initially be treated on demand with bypass therapy until the inhibitor titer has fallen below 10 BU/mL. Patients will then be randomized to receive a high or low-dose regime. Efficacy, cost-effectiveness and morbidity will be compared.
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