Combined prednisolone and intravenous immunoglobulin treatment for acquired factor VIII inhibitors: a 2-year review

Dykes, A.C., Walker, I.D., Lowe, G.D.O. and Tait, R.C. (2001) Combined prednisolone and intravenous immunoglobulin treatment for acquired factor VIII inhibitors: a 2-year review. Haemophilia, 7(2), pp. 160-163. (doi: 10.1046/j.1365-2516.2001.00489.x)

Abstract

Acquired inhibitors to factor VIII (FVIII) are rare, but life- threatening in up to 22% of cases. The optimal therapy for suppression of these inhibitors remains unclear. Prednisolone is the mainstay of therapy, producing responses in approximately 30% of cases. Intravenous immunoglobulin (IVIg) has a similar response rate, but a more rapid effect. We report the results of prednisolone 1 mg kg(-1) combined with IVIg 2 g kg(-1) in divided doses as first-line therapy in seven consecutive patients with acquired FVIII inhibitors. All patients were bleeding at the time of diagnosis with prolonged activated partial thromboplastin time. There were four complete responses, one partial response, one nonresponse and one with an inadequate follow-up for assessment of response, giving an overall response rate of 71%. In all complete responders the inhibitor declined rapidly and was undetectable by day 21 from start of treatment. Therapy was well tolerated and responses have been maintained off treatment for 2-8 months. This is a safe, well-tolerated rapidly acting regimen with good response rates.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Walker, Prof Isobel and Lowe, Professor Gordon and Tait, Dr Robert
• Authors: Dykes, A.C., Walker, I.D., Lowe, G.D.O., and Tait, R.C.
• Subjects: R Medicine > RC Internal medicine; R Medicine > RM Therapeutics. Pharmacology; Q Science > QP Physiology
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Haemophilia
• Publisher: Blackwell Publishing
• ISSN: 1351-8216
• Copyright Holders: © Blackwell Publishing
• First Published: First published in Haemophilia 7(2):160-163
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher