title: DDAVP nasal spray for treatment of menorrhagia in women with inherited bleeding disorders: a randomized placebo-controlled crossover study.
abstract: To assess DDAVP (1-deamino-8-d-arginine vasopressin; desmopressin) nasal spray in the management of menorrhagia in patients with inherited bleeding disorders, 39 women (aged 18-50 years) with menorrhagia were recruited and were randomized to start 2 months' therapy with placebo or DDAVP (300 micro g) spray in a double-blind crossover study. Twenty-eight and 24 completed first and second period of treatment, respectively. Menstrual loss was assessed using the pictorial blood assessment chart (PBAC) during each treatment period. The main outcome measure was comparison of PBAC scores following DDAVP and placebo treatments. The safety of DDAVP spray was also assessed by monitoring side-effects. Overall, PBAC scores were significantly lower in the second treatment period than the first (P = 0.01). After adjusting for this differences, mean PBAC scores were slightly lower (mean difference 8; 95% confidence interval of - 15.5 to 31.6) in women receiving DDAVP than when receiving placebo, although this difference was not statistically significant (P = 0.51). In conclusion, although there was an indication that menstrual bleeding was less heavy when women received DDAVP than when receiving placebo, the small sample size meant that this difference was not significant.
authors.affiliation: University Department of Obstetrics and Gynecology, The Royal Free Hospital, London, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Kadir
authors.forename: C A
authors.initials: CA
authors.lastname: Lee
authors.forename: C A
authors.initials: CA
authors.lastname: Sabin
authors.forename: D
authors.initials: D
authors.lastname: Pollard
authors.forename: D L
authors.initials: DL
authors.lastname: Economides
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D018592:Cross-Over Studies; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008595:Menorrhagia / Q000188:drug therapy* / Q000209:etiology*; D008875:Middle Aged; D016896:Treatment Outcome; D014842:von Willebrand Diseases / Q000150:complications
chemical_list: D006490:Hemostatics; D003894:Deamino Arginine Vasopressin