VWF/FVIII concentrates in high-risk immunotolerance: the RESIST study

Immune tolerance induction (ITI), through the regular infusion of coagulation factor concentrates over a time period ranging from 1 to more than 24 months, is successful in about 75% of high responders. Among the issues of ITI treatment that are still open, the choice of the product to use is one of...

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Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2007-12, Vol.13 (s5), p.73-77
Main Author: GRINGERI, A.
Format: Article
Language:English
Subjects:
Coagulants - immunology
Coagulants - therapeutic use
factor VIII
Factor VIII - immunology
Factor VIII - therapeutic use
haemophilia A
Hemophilia A - drug therapy
Hemophilia A - immunology
Humans
Immune Tolerance
immune tolerance induction
inhibitors
Isoantibodies - analysis
prognostic factors
Prospective Studies
Research Design
von Willebrand factor
von Willebrand Factor - immunology
von Willebrand Factor - therapeutic use
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Summary:Immune tolerance induction (ITI), through the regular infusion of coagulation factor concentrates over a time period ranging from 1 to more than 24 months, is successful in about 75% of high responders. Among the issues of ITI treatment that are still open, the choice of the product to use is one of the most difficult. In fact, common practice is to start with the same product that induced the inhibitory response, but recent findings indicated that plasma‐derived products containing large amounts of von Willebrand factor (VWF) can play a positive role. Two retrospective cohorts in Germany and in France and one prospective cohort have shown a high rate of success when VWF/factor VIII (FVIII) products are used to induce ITI. For these reasons, two prospective studies have been planned to complement the international ITI study already started: an observational study in patients who had already experienced a failure with a VWF‐free FVIII concentrate, called RESISTexp (experienced); a randomized, controlled study in patients who have never tried an ITI treatment before and at high risk to fail, called RESISTnaïve (naïve).
ISSN:1351-8216
1365-2516
DOI:10.1111/j.1365-2516.2007.01579.x