Immunosuppressive treatment for acquired haemophilia: current practice and future directions in Germany, Austria and Switzerland

Tiede, Andreas; Huth-Kühne, Angela; Oldenburg, Johannes; Grossmann, Ralf; Geisen, Ulrich; Krause, Manuela; Brand, Brigit; Alberio, Lorenzo; Klamroth, Robert; Spannagl, Michael; Knöbl, Paul (2009). Immunosuppressive treatment for acquired haemophilia: current practice and future directions in Germany, Austria and Switzerland. Annals of hematology, 88(4), pp. 365-70. Berlin: Springer 10.1007/s00277-008-0665-7

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Acquired haemophilia is an autoimmune disorder characterised by autoantibody formation against coagulation factor VIII. Immunosuppressive treatments including steroids, cytotoxic drugs, rituximab or combinations thereof have been used to eradicate autoantibodies. Very few prospective studies exist evaluating the use of these treatments. Here, we performed a survey among 73 physicians from 57 haemophilia treatment centres in order to describe current practice patterns and critical issues for future research in acquired haemophilia. The results demonstrate a high diversity of first- and second-line treatments. Factors influencing treatment decision were underlying disorder, severity of bleeding and inhibitor titre. Frequently used first-line treatments were steroids plus cyclophosphamide (44%) and steroids alone (11%). Second-line treatment was most often rituximab (30%), with or without steroids and/or cyclophosphamide. Most participants indicated to change from first- to second-line treatment after 4 weeks in case of failure to obtain partial remission (31%), continued bleeding (40%) or continued severe bleeding requiring bypass treatment (59%). Immunoadsorption was preferred for first- and second-line treatment by 10% and 9% of participants, respectively. These results highlight critical issues in the field. Open questions and directions for future research are discussed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Alberio, Lorenzo

ISSN:

0939-5555

Publisher:

Springer

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:10

Last Modified:

04 May 2014 23:22

Publisher DOI:

10.1007/s00277-008-0665-7

PubMed ID:

19083235

Web of Science ID:

000263483900012

URI:

https://boris.unibe.ch/id/eprint/30910 (FactScience: 195270)

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