Recommendations for MHA
| 1. Patients with suspected MHA should be referred to a specialized hemophilia treatment center; |
| 2. Perform genetic testing to identify patients with mutations potentially at risk for inhibitor; |
| 3. Perform a desmopressin challenge in all patients unless a contraindication exists; |
| 4. Use desmopressin where possible, and use caution with high-dose/prolonged courses of FVIII replacement therapy, especially in patients with mutations associated with inhibitor development; |
| 5. Test for inhibitor after 4-6 wk from intensive treatment with FVIII concentrates, before surgery, or at least every 6 or 12 mo if sporadically treated with FVIII concentrates; |
| 6. Record accurately the progressive number of ED to anticipate the onset of inhibitor, especially in patients with high-risk mutations. |
| 1. Patients with suspected MHA should be referred to a specialized hemophilia treatment center; |
| 2. Perform genetic testing to identify patients with mutations potentially at risk for inhibitor; |
| 3. Perform a desmopressin challenge in all patients unless a contraindication exists; |
| 4. Use desmopressin where possible, and use caution with high-dose/prolonged courses of FVIII replacement therapy, especially in patients with mutations associated with inhibitor development; |
| 5. Test for inhibitor after 4-6 wk from intensive treatment with FVIII concentrates, before surgery, or at least every 6 or 12 mo if sporadically treated with FVIII concentrates; |
| 6. Record accurately the progressive number of ED to anticipate the onset of inhibitor, especially in patients with high-risk mutations. |