Desmopressin for the treatment of haemophilia.

Abstract

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.

• Authors: G Castaman
• Journal: Haemophilia : the official journal of the World Federation of Hemophilia (Haemophilia) Vol. 14 Suppl 1 Pg. 15-20 (Jan 2008) ISSN: 1365-2516 [Electronic] England
• PMID: 18173690 (Publication Type: Journal Article, Review)

Chemical References

• Hemostatics
• Deamino Arginine Vasopressin

Topics

• Administration, Intranasal
• Adult
• Child
• Deamino Arginine Vasopressin (administration & dosage, therapeutic use)
• Hemophilia A (drug therapy)
• Hemostatics (administration & dosage, therapeutic use)
• Humans
• Injections, Intravenous