While the treatments discussed in the preceding sections provide options for treating a bleed, they do not have the same positive, long-term outcomes as treatment with replacement factor (VIII or IX) in patients without inhibitors. These less-than-optimal treatments can also lead to secondary problems such as infections, bleeding into joints and organ damage.
Because of these complications, many healthcare providers believe that ridding of the body of inhibitors is the best option. This is done using a course of therapy known as "immune tolerance." There are different treatment programs used for immune tolerance, but most require repeated exposure to the deficient clotting factor.
People who opt for immune tolerance expose themselves to daily doses of factor over a period of weeks, and in some cases, years. Some people going through this therapy are also given immune suppressive drugs, which can predispose one to infections. The risks and benefits of each treatment program and the medications used should be discussed in detail with a healthcare provider. The goal of immune tolerance therapy is to eventually "teach" the body to tolerate the factor and to not mount an immune response so that normal replacement therapy can be used to prevent or control bleeding.
Overall, immune tolerance treatment is highly effective and is thought to work approximately 60% to 80% of the time.