BACKGROUND: von Willebrand disease (VWD) is the most common hereditary bleeding disorder affecting both males and females. It arises from quantitative or qualitative defects of von Willebrand factor (VWF) and causes bleeding of mucous membranes and soft tissues. The aim of treatment is to correct the dual defect of haemostasis caused by the abnormal/reduced VWF and the concomitant deficiency of factor VIII (FVIII). MATERIAL AND METHODS: This document contains evidence-based recommendations for the management of VWD compiled by AICE (the Italian Association of Haemophilia Centres). All the evidence supporting these recommendations are based on non-randomised comparative studies or case series, because randomised controlled clinical trials or meta-analyses are not available for this disease. RESULTS AND CONCLUSIONS: Desmopressin (DDAVP) is the treatment of choice for patients with type 1 VWD with FVIII and VWF levels of 10 U/dL or more, while VWF/FVIII concentrates are indicated for those who are unresponsive or insufficiently responsive to DDAVP (severe type 1, type 2 and 3 VWD). VWF concentrates devoid of FVIII, not yet licensed in Italy, may be considered for short-term prophylaxis in elective surgery or for long-term secondary prophylaxis.
BACKGROUND:von Willebrand disease (VWD) is the most common hereditary bleeding disorder affecting both males and females. It arises from quantitative or qualitative defects of von Willebrand factor (VWF) and causes bleeding of mucous membranes and soft tissues. The aim of treatment is to correct the dual defect of haemostasis caused by the abnormal/reduced VWF and the concomitant deficiency of factor VIII (FVIII). MATERIAL AND METHODS: This document contains evidence-based recommendations for the management of VWD compiled by AICE (the Italian Association of Haemophilia Centres). All the evidence supporting these recommendations are based on non-randomised comparative studies or case series, because randomised controlled clinical trials or meta-analyses are not available for this disease. RESULTS AND CONCLUSIONS: Desmopressin (DDAVP) is the treatment of choice for patients with type 1 VWD with FVIII and VWF levels of 10 U/dL or more, while VWF/FVIII concentrates are indicated for those who are unresponsive or insufficiently responsive to DDAVP (severe type 1, type 2 and 3 VWD). VWF concentrates devoid of FVIII, not yet licensed in Italy, may be considered for short-term prophylaxis in elective surgery or for long-term secondary prophylaxis.
Entities:
Keywords:
desmopressin; von Willebrand disease; von Willebrand factor
Authors: A B Federici; F Baudo; C Caracciolo; G Mancuso; M G Mazzucconi; R Musso; P C Schinco; R Targhetta; P Mannuccio Mannucci Journal: Haemophilia Date: 2002-11 Impact factor: 4.287
Authors: Pier M Mannucci; Juan Chediak; Wahid Hanna; John Byrnes; Marlies Ledford; Bruce M Ewenstein; Anastassios D Retzios; Barbara A Kapelan; Richard S Schwartz; Craig Kessler Journal: Blood Date: 2002-01-15 Impact factor: 22.113
Authors: P A Kyrle; E Minar; M Hirschl; C Bialonczyk; M Stain; B Schneider; A Weltermann; W Speiser; K Lechner; S Eichinger Journal: N Engl J Med Date: 2000-08-17 Impact factor: 91.245