Immune Tolerance Induction (ITI)

ITI is an effective technique to reset the immune system so it does not react to factor VIII treatments. 

A patient, usually with high inhibitor titers, receives regular infusions of factor VIII that continue for months or 2 or more years; a mean of 17 months has been reported.1,2

Each ITI patient on average uses 547,500 IU per year.3 As mentioned, the technique is effective in 70% to 80% of patients.4

Immune tolerance therapy using repeated doses of Factor VIII concentrate administered frequently on a predetermined schedule may result in eradication of the Factor VIII inhibitor.(13,14) Most successful regimens have employed high doses of Factor VIII administered at least once daily, but no single dosage regimen has been universally accepted as the most effective. Consultation with a hemophilia expert experienced with the management of immune tolerance regimens is also advisable.5


References: 1. DiMichele DM, Kroner BL. The North American Immune Tolerance Registry: practices, outcomes, outcome predictors. Thromb Haemost. 2002;87:52–57. 2. 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. 3. Survey on Hemophilia Care and Price Monitoring, United States, Wave #18.Orange, CT: The Marketing Research Bureau Inc.;2008. 4. Dargaud Y, Negrier C. Haemophiliatherapies. Expert Opin Biol Ther. 2007;7:651–663. 5. Koate-DVI [prescribing information]. 2012.