Open Access
CC BY-NC-ND 4.0 · Semin Thromb Hemost
DOI: 10.1055/a-2779-9176
Original Article

Vonicog Alfa versus Plasma-Derived von Willebrand Factor During Hospitalization: Results of an Observational Retrospective Multicenter Study

Authors

  • Valérie Horvais

    1   Nantes Université, CHU Nantes, Unité d'Investigation Clinique 17, Nantes, France
  • Catherine Ternisien

    2   Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes, France
  • Julien Denis-Le-Sève

    3   CHU Angers, Centre de Traitement des Maladies Hémorragiques Constitutionnelles, Angers, France
  • Philippe Beurrier

    3   CHU Angers, Centre de Traitement des Maladies Hémorragiques Constitutionnelles, Angers, France
  • Marc Fouassier

    2   Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes, France
  • Antoine Babuty

    2   Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes, France
  • Nicolas Drillaud

    2   Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes, France
  • Brigitte Pan-Petesch

    4   CHU Brest, Service Hématologie Clinique Hémostase, Brest, France
  • Johann Rose

    5   CH Le Mans, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Le Mans, France
  • Vincent Cussac

    5   CH Le Mans, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Le Mans, France
  • Sophie Bayart

    6   CHU Rennes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Rennes, France
  • Benoît Guillet

    6   CHU Rennes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Rennes, France
    7   Inserm, Rennes Université, EHESP, IRSET (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
  • Marc Trossaërt

    2   Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes, France

Funding Information This study was funded by Baxalta GmbH, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, as part of an investigator-initiated research project (IISR-2021-200066/Sponsor: Nantes University Hospital). Baxalta GmbH played no role in the design and conduct of the study, the collection, management, analysis, or interpretation of the data, or the preparation, writing, review, or approval of the manuscript.

Abstract

Background

Available products for the treatment of von Willebrand disease (VWD) now include a new recombinant von Willebrand factor (rVWF) in addition to plasma-derived concentrates (pdVWF). However, these two therapies have never been compared directly in either preclinical studies or real-world inpatient settings.

Objective

The Hopscotch Will II study examined the treatment of VWD in hospitals and compared the use of pdVWF and rVWF.

Methods

Five Rare Bleeding Diseases Centers in Western France retrospectively included patients with VWD over a 48-month period. The data was collected from the BERHLINGO Research Database as well as the French Hospital database, which contains medical information from patient records.

Results

Of the 866 patients evaluated in the study, 285 underwent 648 hospitalizations; 126 adult patients (VWD type 3 excluded) were given VWF concentrates during 249 of those hospital stays. rVWF was used in 61% of the cases. The majority of the hospitalizations were motivated by cutaneous-mucosal symptoms in gastroenterology, stomatology, gynecology, and obstetrics. Consumption of rVWF was lower, though the difference in total VWF consumption per stay or per patient per year was not significant: 51 (57)/34 (30) IU/kg/patient/year for pdVWF versus 40 (47)/27 (26) for rVWF (mean [SD]/median [IQR], Wilcoxon rank sum test, p = 0.2025).

Conclusion

rVWF was used in similar patient profiles and for identical procedures, but the cost of treatment with rVWF was significantly lower, regardless of whether or not FVIII was added.

Data Availability Statement

The Nantes University Hospital does not plan to share data supporting the results reported in this article.


Contributors' Statement

All authors contributed to the design of the study, the acquisition of data, and the interpretation of data. V.H. and M.T. contributed to the conception of the study and the analysis of data. All authors commented on all intermediary versions of the manuscript (drafting the article or revising it critically for important intellectual content). All authors read and approved the final version of the manuscript to be submitted.


Clinical Trial Registration

The study is registered at www.clinicaltrials.gov under the number NCT04887324 (May 14, 2021).




Publication History

Received: 15 July 2025

Accepted: 21 October 2025

Article published online:
13 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sharma R, Flood VH. Advances in the diagnosis and treatment of von Willebrand disease. Blood 2017; 130 (22) 2386-2391
  • 2 Bowman M, Hopman WM, Rapson D, Lillicrap D, James P. The prevalence of symptomatic von Willebrand disease in primary care practice. J Thromb Haemost 2010; 8 (01) 213-216
  • 3 Sadler JE, Mannucci PM, Berntorp E. et al. Impact, diagnosis and treatment of von Willebrand disease. Thromb Haemost 2000; 84 (02) 160-174
  • 4 Castaman G, Linari S. Diagnosis and treatment of von Willebrand disease and rare bleeding disorders. J Clin Med 2017; 6 (04) 45
  • 5 Peyvandi F, Kouides P, Turecek PL, Dow E, Berntorp E. Evolution of replacement therapy for von Willebrand disease: from plasma fraction to recombinant von Willebrand factor. Blood Rev 2019; 38: 100572
  • 6 El Alayli A, Brignardello Petersen R, Husainat NM. et al. Outcomes of long-term von Willebrand factor prophylaxis use in von Willebrand disease: a systematic literature review. Haemophilia 2022; 28 (03) 373-387
  • 7 Ministère des Solidarités et de la Santé. Arrêté du 14 décembre 2018 modifiant la liste des spécialités pharmaceutiques agréées à l'usage des collectivités et divers services publics. 2018 . Accessed September 15, 2025 at: https://www.legifrance.gouv.fr/download/pdf?id=o4_gmvmogk5ztbgjxvtza9fqnu3rol51x4_ogbphbgy=
  • 8 Franchini M, Mannucci PM. Von Willebrand factor (Vonvendi): the first recombinant product licensed for the treatment of von Willebrand disease. Expert Rev Hematol 2016; 9 (09) 825-830
  • 9 Horvais V, Beurrier P, Cussac V. et al; BERHLINGO Consortium. Key drivers of coagulation factor use in von Willebrand disease during hospitalization: an overview of the French BERHLINGO cohort. Clin Drug Investig 2024; 44 (01) 35-49
  • 10 CRMW. Protocole National de Diagnostic et de Soins (PNDS): Maladie de Willebrand. HAS; 2021 . Accessed January 2, 2026 at: https://www.has-sante.fr/upload/docs/application/pdf/2021-02/maladie_de_willebrand_-_argumentaire.pdf
  • 11 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370 (9596) 1453-1457
  • 12 INSEE. TCRED - Estimations de populations - Ensemble - Loire-Atlantique. 2023 . Accessed February 22, 2024 at: https://www.insee.fr/fr/statistiques/serie/001760124
  • 13 INSEE. TCRED - Estimations de Population - Ensemble - Vendée. 2023 . Accessed February 22, 2024 at: https://www.insee.fr/fr/statistiques/serie/001760165
  • 14 Vallois HV, Marquer P. La répartition en France des groupes sanguins ABO. Bull Mem Soc Anthropol Paris 1964; 6 (01) 1-200
  • 15 FranceCoag. Données démographiques: Maladie de Willebrand. Données au 27/11/ 2023 . FranceCoag. November 27, 2023. Accessed February 27, 2024 at: https://www.francecoag.org/sitewebpublic/public/stats/stats_page.jsp?stat4=on
  • 16 Abbonizio F, Hassan HJ, Riccioni R, Santagostino E, Arcieri R, Giampaolo A. Italian Association of Haemophilia Centres (see Appendix). New data from the Italian National Register of Congenital Coagulopathies, 2016 Annual Survey. Blood Transfus 2020; 18 (01) 58-66
  • 17 Du P, Bergamasco A, Moride Y, Truong Berthoz F, Özen G, Tzivelekis S. Von Willebrand disease epidemiology, burden of illness and management: a systematic review. J Blood Med 2023; 14: 189-208
  • 18 Veyradier A, Boisseau P, Fressinaud E. et al; French Reference Center for von Willebrand disease. A laboratory phenotype/genotype correlation of 1167 French patients from 670 families with von Willebrand disease: a new epidemiologic picture. Medicine (Baltimore) 2016; 95 (11) e3038
  • 19 Leebeek FWG, Eikenboom JCJ. Von Willebrand's Disease. N Engl J Med 2016; 375 (21) 2067-2080
  • 20 Brignardello-Petersen R, El Alayli A, Husainat N. et al. Surgical management of patients with von Willebrand disease: summary of 2 systematic reviews of the literature. Blood Adv 2022; 6 (01) 121-128
  • 21 Peyvandi F, Mamaev A, Wang J-D. et al. Phase 3 study of recombinant von Willebrand factor in patients with severe von Willebrand disease who are undergoing elective surgery. J Thromb Haemost 2019; 17 (01) 52-62
  • 22 Desprez D, Drillaud N, Flaujac C. et al. Efficacy and safety of a recombinant Von Willebrand Factor treatment in patients with inherited Von Willebrand Disease requiring surgical procedures. Haemophilia 2021; 27 (02) 270-276
  • 23 Sun SX, Lowndes S, Willock R, Jones C, Brighton S. Outcomes in patients with von Willebrand disease receiving recombinant von Willebrand factor on demand and in surgical settings: chart review. Clin Appl Thromb Hemost 2023; 29
  • 24 Schulman S, Kearon C. ; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3 (04) 692-694
  • 25 Solimeno LP, Escobar MA, Krassova S, Seremetis S. Major and minor classifications for surgery in people with hemophilia: a literature review. Clin Appl Thromb Hemost 2018; 24 (04) 549-559