Inhibitors typically develop in the first 50 treatment days with most developing in the first 20 days this is why when people with severe haemophilia develop inhibitors it is usually during childhood whilst people with mild or moderate conditions tend to develop them later in life inhibitors are treated with immune tolerance inductioniti iti involves regular exposure to factor treatment with the aim of the body becoming accustomed to the clotting factor studies show that by flooding . Edited by an orthopaedic surgeon and a haematologist who are leading specialists in the treatment of haemophilia inhibitors in patients with haemophilia reviews the different haemostatic products and protocols for the control of bleeding and surgery in haemophilic patients with inhibitors. Some people with hemophilia and von willebrand disease vwd type 3 will develop inhibitors inhibitors make it more difficult to stop a bleeding episode because they prevent the treatment from working if you have hemophilia or vwd type 3 it is important to be tested for inhibitors once a year. Inhibitor development is the most problematic and costly complication of haemophilia treatment inhibitor development depends on a complex multifactorial immune response that is influenced by patient and treatment related factors considerable research is focussed on inhibitor development as well as the mechanism of eradication through immune tolerance induction iti once an inhibitor develops two general treatment options are available to treat acute bleeds through bypassing agents