Intranasal desmopressin (DDAVP) by spray in mild hemophilia A and von Willebrand's disease type I |
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Authors: | S Lethagen A S Harris I M Nilsson |
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Institution: | (1) Department for Coagulation Disorders, University of Lund, Malmö General Hospital, S-21401 Malmö, Sweden;(2) Ferring Research, Box 30561, S-20062 Malmö, Sweden |
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Abstract: | Summary Desmopressin acetate (1-desamino-8-Darginine vasopressin, DDAVP) has mostly been given by the parenteral route for the treatment of mild hemophilia A and von Willebrand's disease type I. In the present study the hemostatic effects of desmopressin acetate administered intranasally by spray in a dose of 300µg and intravenously 0.3–0.4µg/kg were assessed and compared in 8 patients with hemophilia A and 22 patients with von Willebrand's disease type I. A bioequivalent response to intravenous and intranasal desmopressin acetate was found in Factor VIII coagulant activity (VIII:C) in the hemophilia patients. In the von Willebrand patients, an equivalent shortening of the bleeding time was seen after the two modes of administration, even though intravenous injection gave a higher increase in plasma levels of VIII:C and vWF:Ag. In five patients with von Willebrand's disease the duration of the spray effect on VIII:C and vWF:Ag was followed for 24 h. After 12 h the mean level of VIII : C was 1.4, and of vWF:Ag 1.5, times the basal level. The findings suggest that the spray can be recommended for home or prophylactic treatment of patients with mild hemophilia A and von Willebrand's disease. |
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Keywords: | Desmopressin acetate Intranasal spray Intravenous FVIII Hemophilia von Willebrand's disease |
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