Treatment of patients with acquired inhibitors

Sallah, Sabah; Aledort, Louis M.

doi:10.1111/j.1538-7836.2005.01149.x

Cited by 13 publications

(16 citation statements)

References 20 publications

(38 reference statements)

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“…Acute bleeding episodes in patients with low-titre autoantibodies can be treated with plasma-derived or recombinant human FVIII, whereas FVIII-bypassing agents, such as activated prothrombin complex or recombinant FVIIa, are recommended for patients with high-titre autoantibodies (Sallah & Aledort, 2005;Hay et al, 2006). The long-term goal of therapy is to eliminate the FVIII autoantibodies and thus cure the disease.…”

Section: Current Management Of Patientsmentioning

confidence: 99%

“…Although corticosteroids alone or in combination with cyclophosphamide are recommended as initial therapy for the treatment of acquired haemophilia (Sallah & Aledort, 2005;Hay et al, 2006), immunosuppressant and cytotoxic therapies are not always suitable for elderly patients or those with co-morbidities. Moreover, in young female patients, such treatment can compromise fertility (Maillard et al, 2006).…”

Section: Use Of Rituximab In Acquired Haemophiliamentioning

confidence: 99%

“…The long-term goal of therapy is to eliminate the FVIII autoantibodies and thus cure the disease. To this end, it is recommended that immunosuppressant therapy be initiated as soon as acquired haemophilia is diagnosed (Sallah & Aledort, 2005;Hay et al, 2006). Prednisone with or without cyclophosphamide is generally the treatment of choice for initial immunosuppressant therapy, with elimination of inhibitors being achieved in approximately 70% of patients (Hay et al, 2006).…”

Section: Current Management Of Patientsmentioning

confidence: 99%

“…Prednisone with or without cyclophosphamide is generally the treatment of choice for initial immunosuppressant therapy, with elimination of inhibitors being achieved in approximately 70% of patients (Hay et al, 2006). For those patients who do not respond to initial therapy and the 20% of patients who relapse after a first response, second-line therapy may include 2-chlorodeoxyadenosine, ciclosporin A, azathioprine or IVIG (Sallah & Aledort, 2005;Hay et al, 2006).…”

Section: Current Management Of Patientsmentioning

confidence: 99%

“…The two primary treatment objectives are to stop acute bleeding episodes and to eliminate FVIII autoantibodies (Sallah & Aledort, 2005).…”

Section: Current Management Of Patientsmentioning

confidence: 99%

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Rituximab in the treatment of autoimmune haematological disorders

2008

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SummaryCurrent treatment regimens for haematological autoimmune diseases are relatively non-selective and are often associated with considerable toxicity. Recently, it has become clear that B cells play a key role in both the development and perpetuation of autoimmunity, suggesting that B-cell depletion could be a valuable treatment approach for patients with autoimmune diseases. This article reviews data supporting the use of rituximab -an anti-CD20 monoclonal antibody that specifically depletes B cells -in four key autoimmune haematological disorders: idiopathic thrombocytopenic purpura (ITP); autoimmune haemolytic anaemia (AIHA); acquired haemophilia; and thrombotic thrombocytopenic purpura (TTP). Although treatment of ITP, AIHA, acquired haemophilia and TTP with rituximab is still relatively uncommon, results from case series and small phase II trials indicate that patients of all ages can respond to rituximab, irrespective of the number or type of prior treatments that they have received. Moreover, patients with these diseases receiving rituximab experienced predominantly mild adverse events, with only a few serious adverse events reported. These data suggest that rituximab provides an effective and well-tolerated alternative treatment option for patients with ITP, AIHA, acquired haemophilia and TTP, many of whom have limited treatment choices.

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Section: Current Management Of Patientsmentioning

confidence: 99%