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Does ITI Actually Work in Hemophilia B – RPTH Journal
RPTH Journal/LinkedIn
Mar 24, 2026, 15:38

Does ITI Actually Work in Hemophilia B – RPTH Journal

RPTH Journal shared a post on LinkedIn about a recent article by Shaoyu Yin et al, adding:

“Immune tolerance induction (ITI) in hemophilia B: does it actually work?

This systematic review makes one thing clear: ITI in hemophilia B is unpredictable and risky.

What the data show:

Across 125 patients:

  • Success rates vary wildly (from 12.8 pecent to 100 percent)
  • Time to tolerance: approximately 1 to 19 months
  • Multiple attempts often needed

The real challenge: safety

Adverse events are not rare, they’re defining:

  • Allergic reactions: from 0 to 100 percent
  • Nephrotic syndrome: from 0 to 33 percent

These complications are far more common than in hemophilia A.

This is the key issue:

  • No standardized definition of ‘success.’
  • No uniform ITI protocol
  • Small, heterogeneous cohorts

We’re comparing apples to oranges across studies.

Clinical insight

  • ITI can still work, even after failure or allergic reactions
  • But nephrotic syndrome is a major red flag (often treatment-limiting)
  • Immunosuppression is widely used but doesn’t eliminate risk

Big picture

Unlike hemophilia A, where ITI is established: Hemophilia B remains a high-risk, low-predictability space

And until we standardize protocols: We’re optimizing therapy without a common playbook.”

Title: Treatment outcomes, safety, and characteristics of immune tolerance induction in patients with hemophilia B and inhibitors: a systematic review

Authors: Shaoyu Yin, Jiahong Wu, Wen Yang, Hongli Mu, Yuexing Peng, Haoran Lu, Rong Li, Hui Bi, Zeping Zhou

Read the Full Article on Research and Practice in Thrombosis and Haemostasis

Does ITI Actually Work in Hemophilia B - RPTH Journal

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Allergic reactions Haoran Lu Health Hematology Hemophilia B Hemostais Today Hemostasis Today Hongli Mu Hui Bi Immune Tolerance Induction ITI Jiahong Wu Medicine Nephrotic syndrome Research and Practice in Thrombosis and Haemostasis Rong Li RPTH Journal Shaoyu Yin Wen Yang Yuexing Peng Zeping Zhou
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