Abstract Number: PB1133
Meeting: ISTH 2020 Congress
Background: Desmopressin (DDVAP) is an effective and well-tolerated haemostatic drug used for prevention and management of bleeding in patients with inherited bleeding disorders. We provide a single centre experience spanning 30 years.
Aims: Retrospective evaluation of the use of DDAVP in patients with inherited bleeding disorders.
Methods: A retrospective review of the patients registered at the centre with a diagnosis of inherited bleeding disorder and treated with DDAVP between 1989 to December 2019 was undertaken. Information on baseline diagnosis, indication for treatment, laboratory response to treatment and mode of administration of DDAVP reviewed. Treatment response was monitored by observation of factor VIII (FVIII), and von Willebrand factor (VWF) levels (VWF:RCof) prior and 90 minutes post-administration.
Results: A total of 520 eligible patients were identified. The following patients groups were seen; Mild haemophilia A (HA) (n=124), HA carriers (n=61), von Willebrand disease (n=239) platelet disorders (n=77) and patients with combined bleeding disorders (n=16). VWD patients included; type 1 (n=173) (mild, n=126; severe, n=47), type2 (n=71) which included type 2A (n=12), type 2B (n=20), type 2M (n-34), type 2N (n-5). A total of 785 minor procedures were covered with DDVAP. In mild HA, the median FVIII increased from 22 IU/dL to 58 IU/dL, 65% increase. In HA carriers median FVIII increased from 48 IU/dL to 130 IU/dL, increment of 63 %. Patients with VWD, mild type 1 had an increment of FVIII and VWF:RCof levels of 67.6% and 74.3% respectively (median baseline VIII 66 IU/dL and Ricof 30 IU/dL, respectively).
Conclusions: DDVAP was used regularly in our patients with mild bleeding disorders; the responses appear to be higher in HA carriers compared to mild HA and this may be related to the higher baseline levels. Further characterisation of the absolute response to the procedure and bleeding enables development of clinical algorithms.
To cite this abstract in AMA style:Peralta MR, Gration B, Agapidou A, Garcia CD, Yee TT, Riddell A, Gomez K, Hanif Z, Drebes A, Hamid C, Morjaria P, Aradom E, Pollard D, Chowdary P. Desmopressin Response and Clinical Outcome in Bleeding Disorders: A 30 Year Retrospective Analysis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/desmopressin-response-and-clinical-outcome-in-bleeding-disorders-a-30-year-retrospective-analysis/. Accessed January 21, 2022.
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