Immune tolerance therapy for inhibitors in haemophilia A

The development of inhibitors at start of therapy with factor VIII concentrates represent the most serious complication of haemophilia treatment. The only way to along lasting eradication of the inhibitor is the induction of immune tolerance. A successful immune tolerance therapy (ITT) is the precondition for a regular prophylactic treatment regime and subsequently safe life perspective with a good quality of life. All ITT protocols have been developed empirically without knowing the pathophysiological mechanisms. The guidelines of the Federal Chamber of Physicians (1), the German recommendations for ITT (2) and the consensus recommendations of an international working group (3) provide an important lead for the conduction of immune tolerance therapy.