Abstract Number: PB0668
Meeting: ISTH 2021 Congress
Background: Desmopressin is administered nasally (Octim®), intravenously (Minirin®) or subcutaneously (Octostim®). On July 2020, the French National Agency for Medicines and Health Products Safety published a withdrawal for all batches of Octim®currently distributed.
Aims: This situation prompted us to prescribe Octostim® to patients who usually use Octim® to treat their bleeds at least once a month or to newly diagnosed patients.
Methods: The treatment regimen is as follows: injection of 15 µg/mL for patients weighing less than 75 kg and 30 µg/mL for those weighing 75 to 100 kg. At first, 15 patients underwent a therapeutic trial with Octostim® then they were taught how to administer the subcutaneous injection properly. The cohort was composed of 4 patients with minor haemophilia A, 3 haemophiliacs with inhibitor, 1 carrier of haemophilia, and 7 patients with Von Willebrand disease (VWD) including 4 patients who never used desmopressin because their diagnosis was established in August 2020. The average (min-max) age was 32 years (17-75) with a sex-ratio (M/F) of 0.9.
Results: All patients responded favourably to Octostim® with an average increase in factor VIII activity (FVIII) of 249% and Von Willebrand factor activity (VWF:Rco) of 216% for patients with VWD. Comparatively, after an Octim® administration to the same patients, the average increase in FVIII and VWF:Rco were respectively 234% and 211%. These results suggest a bioequivalence between the 2 galenic forms. During the trial, 2 patients reported pain with a burning sensation at the injection site. After 3 months, patients were contacted for follow-up and only 3 of them have actually used Octostim® as self-treatment, respectively for a meno-metrorrhagia, a tooth extraction and a lipectomy.
Conclusions: With a storage temperature of +4°C, the use of Octostim® is much more difficult and inappropriate for an emergency but constitute a good alternative for Octim® responsive patients.
To cite this abstract in AMA style:Wimmer J, Gerout A-, Sattler L, Grunebaum L, Feugeas O, Desprez D. Global Octim® Shortage: Experience in Strasbourg [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/global-octim-shortage-experience-in-strasbourg/. Accessed January 23, 2022.
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