Desmopressin acetate use in von Willebrand’s disease: a survey on current practices in Brazil

Lopes, Maria Sueli da Silva Namen; Rezende, Suely Meireles

doi:10.1016/j.htct.2019.12.004

Cited by 1 publication

(5 citation statements)

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“…A study demonstrated that 30% of patients with type 1 VWD received factor concentrates over the last year, in spite of 69% of these patients having an adequate response 24 . This was confirmed by a survey among physicians involved in the management of VWD in Brazil that reported an unexpected lower use of desmopressin compared with factor concentrates in the treatment of VWD 26 . It is unclear what the underlying reasons are for these observations and whether perceived side effects, estimated to occur in around 30% of patients, 5 pose a substantial barrier for desmopressin use.…”

Section: Discussionmentioning

confidence: 92%

“… 23 Also in this population, discrepancies in the response to desmopressin and its actual clinical use have been noticed. 24 , 25 , 26 A study demonstrated that 30% of patients with type 1 VWD received factor concentrates over the last year, in spite of 69% of these patients having an adequate response. 24 This was confirmed by a survey among physicians involved in the management of VWD in Brazil that reported an unexpected lower use of desmopressin compared with factor concentrates in the treatment of VWD.…”

Section: Discussionmentioning

confidence: 99%

“… 24 This was confirmed by a survey among physicians involved in the management of VWD in Brazil that reported an unexpected lower use of desmopressin compared with factor concentrates in the treatment of VWD. 26 It is unclear what the underlying reasons are for these observations and whether perceived side effects, estimated to occur in around 30% of patients, 5 pose a substantial barrier for desmopressin use. Another possibility for suboptimal use of desmopressin may be related to local differences in costs of desmopressin or the hospital infrastructure, in which the slow infusion rate and in young children monitoring of sodium levels 7 may be considered time‐consuming.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with von Willebrand disease (VWD), desmopressin is considered as an important treatment option as well 23 . Also in this population, discrepancies in the response to desmopressin and its actual clinical use have been noticed 24–26 . A study demonstrated that 30% of patients with type 1 VWD received factor concentrates over the last year, in spite of 69% of these patients having an adequate response 24 .…”

Section: Discussionmentioning

confidence: 99%

“…compared with factor concentrates in the treatment of VWD. 26 It is unclear what the underlying reasons are for these observations and whether perceived side effects, estimated to occur in around 30% of patients, 5 pose a substantial barrier for desmopressin use.…”

Section: Treatment Of Bleedsmentioning

confidence: 99%

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Desmopressin for bleeding in non‐severe hemophilia A: Suboptimal use in a real‐world setting

Zwagemaker

Kloosterman

Coppens

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background Desmopressin is an important treatment option in nonsevere hemophilia A because it has several benefits compared with factor (F) concentrates, including no inhibitor risk and much lower costs. Despite these advantages, data are limited on the real‐world use of desmopressin in the treatment of bleeds. Objective To describe the clinical use of desmopressin in relation to other therapeutic modalities in the treatment of bleeding episodes in patients with nonsevere hemophilia A. Methods Patients with nonsevere hemophilia A aged 12–55 years were included from the DYNAMO cohort study. Data on the desmopressin test response and treated bleeding events in the period January 2009 to July 2020 were retrospectively collected from medical files. An adequate desmopressin test response was defined based on a peak FVIII level of ≥30 IU/dl. Results A total of 248 patients with a median age of 38 years (interquartile range 25–49) were included. An adequate desmopressin test response was documented in 25% and 73% of patients with moderate and mild hemophilia, respectively. In adequate responders, 51% of bleeds were exclusively treated with FVIII concentrates, 24% exclusively with desmopressin, 21% with a combination of both and 4% with other treatments. In 54% of bleeds treated with a single dose of factor concentrates, the expected FVIII level after desmopressin exceeded the level targeted. Conclusion Most bleeds in patients with an adequate response to desmopressin are treated with factor concentrates. These findings may indicate a suboptimal use of desmopressin and that barriers to the use of desmopressin should be explored.

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Section: Discussionmentioning

confidence: 92%