Concentrated DDAVP: Further Improvement in the Management of Mild Factor VIII Deficiencies

A Ghirardini; G Mariani; G lacopino; M C Tirindelli; S Solinas; T Moretti

doi:10.1055/s-0038-1646011

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1987; 58(03): 896-898
DOI: 10.1055/s-0038-1646011

Original Article

Schattauer GmbH Stuttgart

Concentrated DDAVP: Further Improvement in the Management of Mild Factor VIII Deficiencies

Autoren

A Ghirardini

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy
G Mariani

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy
G lacopino

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy
M C Tirindelli

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy
S Solinas

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy
T Moretti

The Department of Human Biopathology, Section of Hematology, University of Roma “La Sapienza”, Rome, Italy

Abstract

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Summary

This study was carried out to evaluate the pharmacological efficacy of a new concentrated 1 Deamino - (8-D-arginine) - vasopressin (DDAVP) preparation. Concentrated DDAVP (C- DDAVP), (40 μg/mL) was given subcutaneously (s.c.) in hemophilia and von Willebrand Disease (vWD), and the response was evaluated in terms of factor VIII/vWF (VUI/von Willebrand Factor) complex response. This response was also compared to that obtained using the currently available commercial preparation (4 μg/mL) given either s.c. or intravenously (i. v.). The maximal f. VIII response after s.c. C-DDAVP was reached one hour after the injection (x:3.6 times the resting values) with an average decline of 15% at two hours. The response to s.c. C- DDAVP in patients with hemophilia was slightly better than thut obtained with the diluted brand, but the difference did not reach any statistical significance even when the schedules were compared in the same patients. In type I (placed normal subtype) vWD, a higher response in terms of factor VIII :C increase in comparison with hemophiliacs was obtained. Doth Ristocetin cofactor activity (RiCof) and bleeding time responded to this vasopressin analogue, when administered subcutaneously.

Keywords

DDAVP - Mild hemophilia - von Willebrand’s disease

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Referenzen

References
1 Mannucci PM, Aberg M, Nilsson IM, Robertson B. Mechanism of plasminogen activator and factor VIII increase after vasoactive drugs. Br J Haemat 1975; 30: 81-93
2 Nilsson IM, Mikaelsson M, Vilhardt M. The effect of intranasal DDAVP on coagulation and fibrinolytic activity in normal patients. Scand J Haemat 1982; 29: 70-74
3 Kohler M, Hellstern P, Miyashita C, von Blohn G, Wenzel E. Comparative study of intranasal, subcutaneous and intravenous administration of Desamino-D-Arginine Vasopressin (DDAVP). Thromb Haemostas 1986; 55: 108-111
4 Mannucci PM, Ruggeri ZM, Pareti FI, Capitanio A. l-deamino-8-D- arginine vasopressin: A new pharmacological approach to the management of haemophilia and von Willebrand’s disease. Lancet 1977; 1: 869-872
5 Mannucci PM, Ruggeri ZM, Pareti FI, Capitanio A. DDAVP in haemophilia. Lancet 1977; 2: 1171-1172
6 Kohler M, Hellstern P, Reiter B, von Blohn G, Wenzel E. The subcutaneous administration of the vasopressin analogue 1-desamino- 8-D-arginine vasopressin in patients with von Willebrand’s disease and hemophilia. Klin Wochenschr 1984; 62: 543-548
7 Mariani G, Ciavarella N, Mazzucconi MG, Antoncecchi S, Solinas S, Ranieri P, Pettini P, Agrestini F, Mandelli F. Evaluation of the effectiveness of DDAVP in surgery and in bleeding episodes in haemophilia and von Willebrand’s disease. Clin Lab Haemat 1984; 6: 229-238
8 Mannucci PM, Canciani MT, Rota L, Donovan BS. Reponse of factor VIII/von Willcbrand factor to DDAVP in healthy subjects and in patients with hemophilia A and von Willebrand’s disease. Br J Haemat 1981; 47: 283-293
9 Dc Sio L, Mariani G, Mazzucconi MG, Chistulini A, Tiiindelli MC, Mandelli F. Comparison between subcutaneous and intravenous DDAVP in mild and moderate haemophilia. Thromb Haemostas 1985; 54: 387-389
10 Langdell RD, Wagner RH, Brinkous KM. Effect of anti hemophilic factor on one stage clotting assay. J Lab Clin Med 1953; 41: 637-644
11 Weiss HJ, Hoyer LW, Rickies FR, Varma A, Rogers J. Quantitative assay of a plasma factor deficient in von Willebrand’s dLea;>c that is necessary for platelet aggregation. Relationship to factor VIII procoagulant activity and antigen content. J Clin Invest 1973; 52: 2708-2716
12 Ruggeri ZM, Mannucci PM, Bader R, Barbui T. Factor VIII related properties in platelets from patients with von Willebrand’s disease. J Lab Clin Med 1978; 91: 132-138
13 Mannucci PM, Lombardi R, Bader R, Vianello L, Federici AB, Solinas S, Mazzucconi MG, Mariani G. Heterogeneity of type I von Willebrand’s disease: evidence for a subgroup with an abnormal von Willebrand factor. Blood 1985; 66: 796-802
14 Weiss HL, Pietu G, Rabinowitz R, Girma JP, Rogers J, Meyer D. Heterogenous abnormalities in the multimeric structure, antigenic properties and plasma-platelet content of factor VIII von Willebrand factor in subtypes of classic (type I) and variant (type IIA) von Willebrand’s disease. J Lab ClinMed 1983; 101: 411-425
15 Armitage P. Statistical methods in medical research. Blackwell Scientific Publication; Oxford: 1970
16 Ockelford PA, Chandrasekhara Menon M, Berry EW. Clinical experience with an arginine vasopressin (DDAVP) in von Willebrand’s disease and mild haemophilia. N Z Med J 1980; 672: 375-378
17 Warrier I, Lusher JM. DDAVP: A useful alternative to blood components in moderate hemophilia A and von Willebrand’s disease. J Ped 1983; 162: 228-233