Therapy
in Hemophilia A with Inhibitors
Give factor VIII concentrate
Therapy for low responders:
If no elevation of VIII:
40 U/Kg will neutralize 1
Bethesda unit/mL for 2 – 3 days
If still there is no response and
patient is bleeding:
Give injections of factor
VIIa – Why?
Switch to porcine factor
VIII
VIIa will activate the common pathway (X to Xa) and thus initiate clot formation.
Try to
initiate tolerance:
Give prednisone or cytoxan
Try to
suppress immune system:
Give high doses of VIII for months
or years
