Immune Tolerance Induction (ITI)

Inhibitors are a major treatment challenge for people with hemophilia A. When inhibitors occur, doctors often recommend immune tolerance induction.

Talk to your healthcare provider about your condition. Inhibitors can only be detected by a blood test.

What is ITI?

ITI is an effective way to “reset” the immune system so it does not fight back against factor VIII therapy.1 ITI usually involves regular infusions of factor VIII. These regular, high-volume infusions may continue for months or even years.2–4

The goal of ITI is to teach the body to accept the factor VIII therapy and not create inhibitors to attack it. Once the immune system is reset, normal replacement therapy can be used to control bleeding again.1 Overall, ITI is effective in 70% to 80% of people with inhibitors.1,4


References: 1. Dargaud Y, Negrier C. Haemophilia therapies. Expert Opin Biol Ther. 2007;7:651–663. 2. DiMichele DM, Kroner BL. The American Immune Tolerance Registry: practices, outcomes, outcome predictors. Thromb Haemost. 2002;87:52–57. 3. Mariani G, Kroner B. Immune Tolerance Study Group (ITSG). Immune tolerance in hemophilia with factor VIII inhibitors: predictors of success. Haematologica. 2001;86:1186–1193. 4. National Hemophilia Foundation website. Immune tolerance. www.hemophilia.org. Accessed September 17, 2014.