Side effects of desmopressin in patients with bleeding disorders

Stoof, Sara C. M.; Cnossen, Marjon H.; Maat, Moniek P.M. de; Leebeek, Frank W.G.; Kruip, Marieke J.H.A.

doi:10.1111/hae.12732

Cited by 48 publications

(49 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DDAVP is considered safe but may have mild side effects, such as flushing, transient headache, or hypotension [ 46 ]. To prevent occurrence of more severe side effects such as hyponatremia and cardiovascular events, fluid intake should be restricted to 1500 ml during the first 24 h after administration of the drug.…”

Section: Current Treatment Optionsmentioning

confidence: 99%

Current and Emerging Options for the Management of Inherited von Willebrand Disease

Heijdra

Cnossen

Leebeek

2017

Drugs

View full text Add to dashboard Cite

Von Willebrand disease (VWD) is the most common inherited bleeding disorder with an estimated prevalence of ~1% and clinically relevant bleeding symptoms in approximately 1:10,000 individuals. VWD is caused by a deficiency and/or defect of von Willebrand factor (VWF). The most common symptoms are mucocutaneous bleeding, hematomas, and bleeding after trauma or surgery. For decades, treatment to prevent or treat bleeding has consisted of desmopressin in milder cases and of replacement therapy with plasma-derived concentrates containing VWF and Factor VIII (FVIII) in more severe cases. Both are usually combined with supportive therapy, e.g. antifibrinolytic agents, and maximal hemostatic measures. Several developments such as the first recombinant VWF concentrate, which has been recently licensed for VWD, will make a more “personalized” approach to VWD management possible. As research on new treatment strategies for established therapies, such as population pharmacokinetic-guided dosing of clotting factor concentrates, and novel treatment modalities such as aptamers and gene therapy are ongoing, it is likely that the horizon to tailor therapy to the individual patients’ needs will be extended, thus, further improving the already high standard of care in VWD in most high-resource countries.

show abstract

Section: Current Treatment Optionsmentioning

confidence: 99%

Current and Emerging Options for the Management of Inherited von Willebrand Disease

Heijdra

Cnossen

Leebeek

2017

Drugs

View full text Add to dashboard Cite

show abstract

“…Therefore, both under‐ and over‐diagnosis of mild bleeding disorders should be avoided. Patients with a bleeding disorder should have access to the proper medical treatment, but healthy individuals should not needlessly be exposed to potential complications of hemostatic therapy .…”

Section: Introductionmentioning

confidence: 99%

A diagnostic approach to mild bleeding disorders

Boender

Kruip

Leebeek

2016

Journal of Thrombosis and Haemostasis

Self Cite

View full text Add to dashboard Cite

To cite this article: Boender J, Kruip MJHA, Leebeek FWG. A diagnostic approach to mild bleeding disorders. J Thromb Haemost 2016; 14:1507-16.Summary. Mild inherited bleeding disorders are relatively common in the general population. Despite recent advances in diagnostic approaches, mild inherited bleeding disorders still pose a significant diagnostic challenge. Hemorrhagic diathesis can be caused by disorders in primary hemostasis (von Willebrand disease, inherited platelet function disorders), secondary hemostasis (hemophilia A and B, other (rare) coagulant factor deficiencies) and fibrinolysis, and in connective tissue or vascular formation. This review summarizes the currently available diagnostic methods for mild bleeding disorders and their pitfalls, from structured patient history to highly specialized laboratory diagnosis. A comprehensive framework for a diagnostic approach to mild inherited bleeding disorders is proposed.

show abstract

“…Side effects when using nasal desmopressin are common (68% in a case review of 40 patients), 39 the most common of which are headache, fatigue, flush, itchy eyes, and dizziness, which generally subside after 24 hours. 40,41 Although most adverse events are mild, some require medical attention and can be serious. 39,41 Fluid restriction is important to avoid iatrogenic hyponatremia, and tachyphylaxis occurs with repeated dosing.…”

Section: Casementioning

confidence: 99%

How I treat type 2B von Willebrand disease

Kruse‐Jarres

Johnsen

2018

Blood

View full text Add to dashboard Cite

Type 2B von Willebrand disease (VWD) is an inherited bleeding disorder caused by changes in von Willebrand factor (VWF) that enhance binding of VWF to GPIb on platelets. Although this disorder is seemingly well defined because of this single molecular defect, in reality type 2B VWD is a clinically heterogeneous disorder that can be difficult to identify and manage. Diagnostic criteria include a history of mucocutaneous bleeding, laboratory studies showing enhanced VWF binding of platelets and/or a 2B VWD genetic variant, and a family history consistent with autosomal dominant inheritance. Thrombocytopenia, although not always present, is common and can be exacerbated by physiologic stressors such as pregnancy. The mainstay of therapy for type 2B VWD is VWF replacement therapy. Adjunct therapies useful in other types of VWD, such as antifibrinolytics, are also used in type 2B VWD. 1-Desamino-8-d-arginine vasopressin (DDAVP) is controversial because of exacerbation of thrombocytopenia, but is, in practice, sometimes used for minor bleeding. Here we review the available evidence and provide 3 clinical cases to illustrate the intricacies of diagnosing type 2B VWD to describe the response to DDAVP and to review complexities and management during pregnancy.

show abstract

Side effects of desmopressin in patients with bleeding disorders

Abstract: Observed side effects correspond with the known antidiuretic and vasomotor effects of desmopressin. Changes in parameters were temporary and not clinically relevant. In conclusion, our study supports desmopressin use as a safe treatment option in patients with various bleeding disorders.

Cited by 48 publications

References 39 publications

Current and Emerging Options for the Management of Inherited von Willebrand Disease

Current and Emerging Options for the Management of Inherited von Willebrand Disease

A diagnostic approach to mild bleeding disorders

How I treat type 2B von Willebrand disease

Contact Info

Product

Resources

About