Desmopressin for the treatment of haemophilia
2007; Wiley; Volume: 14; Issue: s1 Linguagem: Inglês
10.1111/j.1365-2516.2007.01606.x
ISSN1365-2516
Autores Tópico(s)Blood transfusion and management
ResumoSummary. The synthetic vasopressin analogue (1–deamino‐8‐ d ‐arginine‐vasopressin) increases plasma concentration of factor VIII and von Willebrand factor in normal subjects and patients with mild haemophilia A and von Willebrand disease. Since its first clinical use in 1977, desmopressin has become the treatment of choice for patients with haemophilia A and factor VIII coagulant activity (FVIII:C) > 5% and has spared several patients the risk of acquiring blood‐borne viral infections due to the use of non‐virally inactivated plasma‐derived FVIII concentrates. An average two to sixfolds FVIII:C increase is typically observed in most patients and return to baseline occurs usually within 8 hours. Several clinical studies have demonstrated the clinical efficacy and safety of desmopressin and the availability of concentrated formulation for subcutaneous injection and of a nasal spray has paved the way to home‐treatment. However, overall it appears that haemophilic children may have a lower rate of biologic response compared to adults and a minority of adult patients are not able to attain clinically useful FVIII:C levels post‐desmopressin administration. Thus, in every patient with haemophilia A likely to be treated or candidate to an elective invasive procedure, a test‐infusion/injection should be carried out to assess the future usefulness of the compound.
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