1-Deamino-8-D-Arginine Vasopressin: A New Pharmacological Approach to the Management of Haemophilia and Von Willebrand's Disease

Pm, Mannucci; Pareti, F. I.; Ruggeri, Zaverio M.; Capitanio, A

doi:10.1016/s0140-6736(77)91197-7

Cited by 600 publications

(313 citation statements)

References 13 publications

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“…DDAVP has been shown to release vWF/VIII-RAG, factor VIII-antihaemophilic and plasminogen activator from endothelial storage sites [16,20]. This drug is used as an alternative to plasma derivatives in the treatment of patients with mild von Willebrand's disease or haemophilia, in the preparation for minor surgery [21].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, patients with insulin-dependent diabetes and normal subjects were given 1-deamino-8-Darginine vasopressin (DDAVP), a vasopressin analogue that releases vWF from endothelial cells [16]. The aims of the study were to investigate (a) the endothelial availability of vWF in patients with an increased plasma pool of this factor and (b) the behaviour of platelet adhesiveness and aggregation following changes of plasma vWF levels in these experiments.…”

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confidence: 99%

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Availability of endothelial von Willebrand factor and platelet function in diabetic patients infused with a vasopressin analogue

Porta

1982

Diabetologia

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Summary. Acute release of von Willebrand factor and its immunologically detected correspondent, factor VIII-related antigen, from the endothelial ceils into the circulation was induced by an infusion of 1-deamino-8-D-arginine vasopressin in eight normal subjects and eight insulin-dependent diabetic patients. The patients had higher basal levels of von Willebrand factor (140 + 13%) and VIII-related antigen (112 • 18%) than the normal subjects (95 • 5% and 70 • 8%, respectively). 1-deamino-8-D-arginine vasopressin induced a twofold rise of these levels in both groups, yon Willebrand factor/ VIII-related antigen remaining higher in the diabetic patients throughout the experiment. In the normal subjects, platelet retention in glass bead columns increased soon after the infusion but returned to basal values after 2 h. In the patients, it remained high at the end of the infusion. No changes in platelet aggregation occurred. These results suggest that increased plasma yon Willebrand factor/VIII-related antigen in diabetic patients is accompanied by an increased endothelial content of this factor.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Availability of endothelial von Willebrand factor and platelet function in diabetic patients infused with a vasopressin analogue

Porta

1982

Diabetologia

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“…DDAVP increases factor VIII (FVIII) and von Willebrand factor (VWF) plasma concentrations without important side effects when administered to healthy volunteers or patients with mild hemophilia and von Willebrand disease (VWD) [2,3]. The first clinical trial of DDAVP was successfully performed in 1977, with the aim of avoiding the use of blood products in mild hemophilia and VWD patients who needed dental extractions and other surgical procedures [4]. Following these early observations, DDAVP has become widely used for the treatment of these diseases [5].…”

Section: Introductionmentioning

confidence: 99%

The use of desmopressin as a hemostatic agent: A concise review

Franchini

2007

American J Hematol

126

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Desmopressin, a synthetic derivative of the antidiuretic hormone vasopressin, is the treatment of choice for most patients with von Willebrand disease and mild hemophilia A. Moreover, the compound has been shown to be useful in a variety of inherited and acquired hemorrhagic conditions, including some congenital platelet function defects, chronic liver disease, uremia, and hemostatic defects induced by the therapeutic use of antithrombotic drugs such as aspirin and ticlopidine. Finally, desmopressin has been used as a blood saving agent in patients undergoing operations characterized by large blood loss and transfusion requirements, but studies suggest that this is not as effective as other methods. This review briefly summarizes the current clinical indications on the use of desmopressin as a hemostatic agent. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.

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“…First described as a treatment for VWD in 1977, 3 DDAVP raises VWF levels through its action on vasopressin V2 receptors, which increase VWF and factor VIII (FVIII) secretion from Weibel-Palade bodies inside endothelial cells into the circulation 4 (Table 1). Definitions of adequate response vary, but to be effective, VWF: RCo and FVIII:C levels should increase at least 2-to 3-fold and to levels Ͼ50%.…”

Section: Raising Vwf Levels: Increasing Endogenous Production Ddavpmentioning

confidence: 99%

Management of VWD

Neff

Sidonio

2014

Hematology

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VWD is the most common inherited bleeding disorder known. It is caused by a deficiency or dysfunction of the VWF molecule. Bleeding risk varies between modest increases in bleeding seen only with procedures to major risk of spontaneous hemorrhage depending upon the type of VWD. The treatment approach to VWD has changed little in the past 2 decades, but there are numerous subtleties in optimal management. Management includes the prevention or treatment of bleeding by raising endogenous VWF levels with medications such as desmopressin or providing exogenous VWF concentrates. Fibrinolytic inhibitors and topical hemostatic agents are also effective adjunctive measures. Bleeding specific to women presents a special challenge because of heavy menstrual bleeding and pregnancy. Successful management of pregnancy in patients with VWD involves coordination with obstetrics, anesthesia, and the coagulation laboratory monitoring VWF:RCo and FVIII:C levels. Prophylactic treatment with VWF concentrates is emerging as an effective preventive therapy in patients with severe disease. Antibodies to VWF present a special challenge in the management of rare patients with type 3 disease. New therapies on the horizon include recombinant VWF, anti-VWF aptamers, and medications such as IL-11 to raise VWF levels. The key to effective treatment of VWD is an accurate diagnosis of the specific type and selection of hemostatic products appropriate for the clinical situation. Learning Objective• To learn the basic principles of management for all types of inherited VWD to implement into clinical practice

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1-Deamino-8-D-Arginine Vasopressin: A New Pharmacological Approach to the Management of Haemophilia and Von Willebrand's Disease

Cited by 600 publications

References 13 publications

Availability of endothelial von Willebrand factor and platelet function in diabetic patients infused with a vasopressin analogue

Availability of endothelial von Willebrand factor and platelet function in diabetic patients infused with a vasopressin analogue

The use of desmopressin as a hemostatic agent: A concise review

Management of VWD

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