Response to desmopressin of factors XI, X and V in patients with factor VIII deficiency and von Willebrand disease

• Published in: British journal of haematology Vol. 126; no. 1; pp. 100 - 104
• Main Authors: White, B., Lawler, P., Riddell, A., Nitu‐Whalley, I. C., Hermans, C., Lee, C. A., Brown, S. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.07.2004; Blackwell; Blackwell Publishing Ltd
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood Coagulation Factors - analysis; Child; Deamino Arginine Vasopressin - therapeutic use; desmopressin; factor V; Factor V - analysis; factor X; Factor X - analysis; Factor XI - analysis; factor XI deficiency; Female; Hematologic and hematopoietic diseases; Hematology; Hemophilia A - blood; Hemophilia A - drug therapy; Hemostatics - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Platelet diseases and coagulopathies; Statistics, Nonparametric; Treatment Failure; von Willebrand disease; von Willebrand Diseases - blood; von Willebrand Diseases - drug therapy; Human; Desmopressin; Hematology; Deficiency; Willebrand disease; factor XI deficiency; Factor VIII; Hemopathy; Genetic disease; Factor V; Factor XI; Factor X; Antidiuretic; Neurohypophyseal hormone; von Willebrand disease; Coagulopathy
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/j.1365-2141.2004.04988.x

Summary Desmopressin [1‐deamino‐8‐d‐arginine vasopressin (DDAVP)] has been successfully used in the treatment of type 1 von Willebrand disease (VWD) and mild haemophilia A (MHA). Data suggest that DDAVP can increase factor XI (FXI) plasma levels and may represent an effective treatment for mild FXI deficiency. We assessed the DDAVP response of FXI coagulant activity (FXI:C), FXI antigen (FXI:Ag), factor V coagulant activity (FV:C), and factor X coagulant activity (FX:C) in 33 individuals with VWD or MHA. DDAVP did not produce a clinically significant increase in FXI:C, FXI:Ag, FX:C or FV:C in any patient. The mean ± SD FXI:C pre‐DDAVP (time 0) and at 1 h post‐DDAVP was 90·7 (±22·9) U/dl and 92·1 (±20·9) U/dl, respectively. The mean (±SD) FXI:Ag at time 0 and 1 h was 92·2 (±20·1) U/dl and 89·9 (±21·3) U/dl, respectively. There was a small reduction at 1 h post‐DDAVP in both FV:C, from 101·8 (±20·9) U/dl to 97·2 (±21·4) U/dl (P < 0·001), and FX:C from 103 (±19·5) U/dl to 98·8 (±18·7) U/dl (P < 0·001). No significant increase in FXI:C, FXI:Ag, FV:C or FX:C levels was seen at 4 h post‐DDAVP. This study failed to demonstrate a clinically significant increase in the levels of FXI, FX or FV following administration of DDAVP.