Desmopressin in treatment of haematological disorders and in prevention of surgical bleeding.
Stimulation with the vasopressin analogue desmopressin (DDAVP) of extrarenal arginine vasopressin (AVP) V2-receptors in endothelial cells and possible in platelets increases the circulating levels of coagulation factor VIII (FVIII), von Willebrand factor (VWF) and tissue plasminogen activator (t-PA). The purpose of this paper is to provide an updated review of current information on the efficacy and safety of DDAVP in the treatment of haemophilia, von Willebrand disease (VWD), uremia, liver cirrhosis, and in congenital or drug-induced platelet dysfunction--under surgical or non-surgical conditions. In summary, desmopressin is an effective haemostatic drug that when administered i.v., s.c. or intranasally increases plasma levels of FVIII and VWF 2-6 times and improves platelet function. It has a proven haemostatic efficacy in mild haemophilia A and VWD as well as in uremia, liver cirrhosis and in congenital and acquired, drug induced platelet dysfunction. Desmopressin has few side effects but observation is advised in small children and elderly.
Lund University, Centre for Thrombosis and Haemostasis, Skane University Hospital, 205 02 Malmö, Sweden. Electronic address: peter.svensson@med.lu.se.
Peter J
PJ
Svensson
Ferring Pharmaceuticals A/S, Kay Fiskers Plads 11, 2300 Copenhagen S, Denmark. Electronic address: pbe@ferring.com.
Peter B F
PB
Bergqvist
Ferring Pharmaceuticals A/S, Kay Fiskers Plads 11, 2300 Copenhagen S, Denmark. Electronic address: kvj@ferring.com.
Kristian Vinter
KV
Juul
Lund University, Centre for Thrombosis and Haemostasis, Skane University Hospital, 205 02 Malmö, Sweden. Electronic address: erik.berntorp@med.lu.se.
Erik
E
Berntorp
D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D006402:Hematologic Diseases / Q000188:drug therapy*; D006801:Humans
D003894:Deamino Arginine Vasopressin
Desmopressin; Haematological disorders; Haemophilia; Surgical bleeding; von Willebrand disease