>Perhaps we should view severe hemophilia with inhibitors as the most important acquired form of clotting disorder.<
Agreed.
>My understanding is that this condition occurs in hemophilia patients who become immune to administration of standard treatment due to an immune mechanism.<
In most diseases, this predicament is described as having neutralizing antibodies. For some reason, the term inhibitors is preferred in hemophilia.
>Factor VII, being later in the extrinsic pathway, is able to bypass that defect. I suppose the reason Factor VII is not used all the time is mostly expense.<
The expense may be part of the reason, but it’s probably not the whole reason. It’s simply a “cleaner” solution to give a patient the coagulation factor he lacks (XIII or IX, as the case may be) if there are no neutralizing antibodies to render that approach unworkable.
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