Intranasal desmopressin (DDAVP) by spray in mild hemophilia A and von Willebrand's disease type I.
Desmopressin acetate (1-desamino-8-D-arginine 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 300 micrograms and intravenously 0.3-0.4 micrograms/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.
Lethagen
S
S
Department of Coagulation Disorders, University of Lund, Malmö General Hospital, Sweden.
Harris
A S
AS
Nilsson
I M
IM
D000281:Administration, Intranasal; D000941:Antigens / Q000032:analysis; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage* / Q000627:therapeutic use; D005169:Factor VIII / Q000378:metabolism; D006467:Hemophilia A / Q000097:blood / Q000188:drug therapy*; D006487:Hemostasis; D006801:Humans; D007275:Injections, Intravenous; D014842:von Willebrand Diseases / Q000097:blood / Q000188:drug therapy*; D014841:von Willebrand Factor / Q000276:immunology
D000941:Antigens; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin