16. On the Use of Desmopressin in von Willebrand Disease

  1. Augusto B. Federici MD4,
  2. Christine A. Lee MA, MD, DSc (Med), FRCP, FRCPath, FRCOGad eundem5,
  3. Erik E. Berntorp MD, PhD6,
  4. David Lillicrap MD7 and
  5. Robert R. Montgomery MD8,9
  1. Stefan Lethagen MD, PhD1,2,
  2. Augusto B. Federici MD4 and
  3. Giancarlo Castaman MD3

Published Online: 21 MAR 2011

DOI: 10.1002/9781444329926.ch16

Von Willebrand Disease: Basic and Clinical Aspects

Von Willebrand Disease: Basic and Clinical Aspects

How to Cite

Lethagen, S., Federici, A. B. and Castaman, G. (2011) On the Use of Desmopressin in von Willebrand Disease, in Von Willebrand Disease: Basic and Clinical Aspects (eds A. B. Federici, C. A. Lee, E. E. Berntorp, D. Lillicrap and R. R. Montgomery), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444329926.ch16

Editor Information

  1. 4

    Division of Hematology and Transfusion Medicine, L. Sacco University Hospital, Department of Internal Medicine, University of Milan, Milan, Italy

  2. 5

    University of London, London, UK

  3. 6

    Malmö Centre for Thrombosis and Haemostasis, Lund University, Skåne University Hospital, Malmö, Sweden

  4. 7

    Department of Pathology and Molecular Medicine, Richardson Laboratory, Queen's University, Kingston, ON, Canada

  5. 8

    Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

  6. 9

    Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI, USA

Author Information

  1. 1

    Copenhagen Haemophilia Centre, Thrombosis and Haemostasis Unit, Department of Haematology, Copenhagen University Hospital (Rigshopsitalet), Copenhagen, Denmark

  2. 2

    Medical & Science Haemostasis Department, Global Development, Novo Nordisk, Søborg, Denmark

  3. 3

    Department of Cell Therapy and Hematology, Hemophilia and Thrombosis Center, San Bortolo Hospital, Vicenza, Italy

  4. 4

    Division of Hematology and Transfusion Medicine, L. Sacco University Hospital, Department of Internal Medicine, University of Milan, Milan, Italy

Publication History

  1. Published Online: 21 MAR 2011
  2. Published Print: 25 MAR 2011

ISBN Information

Print ISBN: 9781405195126

Online ISBN: 9781444329926

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Keywords:

  • desmopressin;
  • DDAVP;
  • vasopressin;
  • von Willebrand disease;
  • hemophilia;
  • tranexamic acid;
  • factor VIII;
  • von Willebrand factor;
  • hemostasis;
  • bleeding

Summary

Desmopressin is an attractive hemostatic agent for the treatment, or prevention, of bleeds in selected patients with von Willebrand disease (VWD) and hemophilia A because it is less costly than factor concentrates and does not involve the risk of transmitting blood-borne disorders. Desmopressin stimulates the endogenous hemostasis by releasing coagulation factor VIII (FVIII) and von Willebrand factor (VWF) from endogenous storage sites. Desmopressin is given in standard dosages, either intravenously or intranasally by spray. FVIII and VWF usually increase between twofold and fourfold, but there is a huge interindividual variation and some individuals may have much higher response. In VWD, most patients with type 1 respond well, whereas only few with type 2 and none with type 3 respond. The strong antidiuretic effect is the most serious side-effect. Other side-effects are usually mild, for example a facial flush or a slight drop in blood pressure, owing to vasodilatation.