Laboratory response to intranasal desmopressin in women with menorrhagia and platelet dysfunction

Rose, Shelonitda S.; Faiz, Ambarina S.; Miller, Connie H.; Saidi, Parvin; Philipp, Claire S.

doi:10.1111/j.1365-2516.2008.01655.x

Cited by 15 publications

(6 citation statements)

References 43 publications

(58 reference statements)

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“…No change in platelet function was observed. As expected, IN-DDAVP raised VWF levels two to threefold but, of interest among those patients with a platelet function defect, there was a strong inverse correlation between the PBAC and FVIII coagulant activity and VWF levels following treatment (Rose et al, 2008).…”

Section: Discussionsupporting

confidence: 71%

Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid

Byams²,

et al. 2009

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Summary The optimal management of menorrhagia among women with abnormal laboratory haemostasis is uncertain. In a crossover study, 116 women with menorrhagia [pictorial blood assessment chart (PBAC) score >100], negative gynaecological evaluation and abnormal laboratory haemostasis were randomly assigned to either intranasal desmopressin (IN‐DDAVP) or tranexamic acid (TA) therapy for two menstrual cycles. The subjects then crossed over to the second study drug for two additional cycles. Menstrual blood loss (MBL) was measured by PBAC scores at baseline and after each menstrual cycle. Quality of life (QOL) was assessed with four validated instruments. There was a statistically significant decrease in PBAC scores for both treatments. On average, the estimated decrease in the PBAC from baseline was −64·1 [95% confidence interval (CI) = −88·0, −40·3] for IN‐DDAVP and −105·7 (95% CI = −130·5, −81·0) for TA. The decrease in PBAC score was greater for TA than IN‐DDAVP (a difference of 41·6, P‐value = 0·0002, 95% CI = 19·6, 63·6). The test for treatment‐type effect was significant (P < 0·0001) suggesting a greater reduction in PBAC score with TA. Use of both IN‐DDAVP and TA improved QOL by all four instruments. We conclude that both medications reduced MBL and improved QOL among females with menorrhagia and abnormal laboratory haemostasis, but TA proved more effective.

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Section: Discussionsupporting

confidence: 71%

Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid

Byams²,

et al. 2009

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“…The role of the PFA-100 in the monitoring of therapy for VWD has also been evaluated by several studies, 49,50,[74][75][76][77][78][79][80][81][82][83][84] and has previously been summarized by this author. [15][16][17][18] Where evaluated, PFA-100 CT responses also tended to provide more utility than did the SBT.…”

Section: Role Of the Pfa-100 In The Identification Of Vwdmentioning

confidence: 99%

“…The role of the PFA-100 in the monitoring of therapy for platelet function disorders using DDAVP therapy has also been evaluated by a limited number of studies. 78,81,82,85 DDAVP therapy is clinically useful for some platelet disorders, and notably SPDs and PSDs. In such individuals, baseline SBT and C/Epi CT (but not C/ADP CT) tend to be prolonged.…”

Section: Role Of the Pfa-100 In The Monitoring Of Treatment For Platementioning

confidence: 99%

Clinical Utility of the PFA-100

Favaloro

2008

Semin Thromb Hemost

285

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“…The non-transfusional agent desmopressin (DDAVP, 1-desamino-8-D-arginine vasopressin) is a synthetic analogue of the antidiuretic hormone vasopressin (45)(46)(47). It increases plasma concentration of VWF and factor VIII in the circulation and increases platelet adhesiveness.…”

Section: Desmopressinmentioning

confidence: 99%

Menorrhagia and bleeding disorders in adolescent females

Halimeh¹

2012

Hamostaseologie

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SummaryIn women, von Willebrand disease (VWD) is the most common inherited bleeding disorder. Since VWD and other inherited bleeding disorders are autosomal disorders, they affect women and men. Menorrhagia, or heavy menstrual bleeding (HMB), is the most common symptom of women with bleeding disorder experience. Objectively, it is defined as bleeding that lasts for more than seven days or results in the loss of more than 80 ml of blood per menstrual cycle. The prevalence of menorrhagia in a woman with a bleeding disorder ranges from 32 to 100% in patients with VWD, from 5 to 98% in patients with a platelet dysfunction and from 35 to 70% in women with a rare factor deficiency. A detailed history and a careful physical exam are the first steps towards a diagnosis in adolescents, adding a PBAC > 100 increased the sensitivity of the screening tool further to 95%. Laboratory testing should be made at the time of menstrual bleeding in an effort to capture the lowest level of VWF : Ag and FVIII : C. Treatment options for menorrhagia in VWD: (1) antifibrinolytic therapy with tranexamic acid, (2) the non-transfusional agent desmopressin (DDAVP), (3) purified blood products that contain factor VIII and VWF concentrated from plasma and (4) hormonal preparations.

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Laboratory response to intranasal desmopressin in women with menorrhagia and platelet dysfunction

Cited by 15 publications

References 43 publications

Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid

Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid

Clinical Utility of the PFA-100

Menorrhagia and bleeding disorders in adolescent females

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