In some @entity1 with @entity447 , therapeutically administered @entity2801 ( @entity2801 ) comes to stimulate the production of antibodies (inhibitors) which react with @entity2801 to render it ineffective. As a result, @entity2801 cannot be used prophylactically and @entity1 become liable to recurrent @entity548 . There are two elements to the management of @entity1 with inhibitors: the treatment of @entity548 episodes, and attempts to abolish inhibitor production through the induction of immune tolerance. This paper reports a systematic review of the best available evidence of clinical effectiveness in relation to immune tolerance induction (ITI) in @entity1 with @entity447 with inhibitors. Owing to the lack of randomized controlled trials on this topic, broad inclusion criteria with regard to study design were applied in order to assess the best available evidence for each intervention. As a result of the clinical and methodological heterogeneity of the evidence, it was not appropriate to pool data across studies; instead, data were synthesized using tabulation and qualitative narrative assessment. The International Registry provides the most reliable estimate of the proportion of successful cases of ITI [48.7%, 95% confidence interval (CI) 42.6-52.7%]. The duration of effect is unclear, but relapses appear to be infrequent. The International Registry shows a rate of relapse of 15% at 15 years. The comparative effectiveness of different protocols is uncertain, as no trials have been undertaken which compare them directly. However, the evidence suggests that the Bonn protocol may be more effective than the Malm   or low-dose protocols. There is no good evidence that immunosuppressive drug regimens are effective.

Immune tolerance induction in @entity1 with XXXX with inhibitors: a systematic review.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2801 :: ('2157', 'Gene') :: ['FVIII', 'factor VIII'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding', 'bleeds'] @entity447 :: ('MESH:D006467', 'Disease') :: ['haemophilia A']
@entity447 :: (MESH:D006467,Disease) :: ['haemophilia A']
