How the Development of Inhibitors Affects Hemophilia Patients

Some hemophilia patients may, over time, develop inhibitors which restrict the efficacy of treatment making bleeding episodes more difficult to stop.

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According to the Centers for Disease Control and Prevention (CDC), although the majority of people living with hemophilia will be able to enjoy a long and healthy life thanks to treatments such as clotting factors, a small percentage of hemophilia patients will develop antibodies known as inhibitors which will block the treatments.

Approximately 20 percent of people with hemophilia A and 3 percent of people with hemophilia B will develop inhibitors — a costly and dangerous complication. If a person develops an inhibitor, the body rejects the clotting factor they infuse which prevents the treatment from working, potentially leading to a dangerous bleed.

Hemophilia patients who develop inhibitors will need special treatment if they have a bleeding episode which can be both expensive and life-threatening. People living with hemophilia who have inhibitors are two times more likely to be hospitalized for a bleeding episode.

Inhibitors tend to develop within the first 50 clotting factor infusions, although it can happen at any time. Hemophilia patients with certain gene mutations are more likely to develop inhibitors, other risks include a family history of inhibitors, race (black and Hispanic people are more at risk), increased frequency of clotting factor treatment, increased dosage of clotting factor treatment, and the number of lifetime exposures a person has to clotting factor.

Diagnosis of inhibitors is done via a simple blood test and it’s recommended that hemophilia patients are tested once a year for the presence of inhibitors. Treatment can be complicated and often involves giving higher dosages or more frequent sessions of clotting factor, using bypassing agents to bypass the inhibitors, and immune tolerance therapy (ITT) which aims to stop the inhibitor from blocking the clotting factor and trick the body into thinking the clotting factor is a normal part of their blood.

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