Comparison Between Subcutaneous and Intravenous DDAVP in Mild and Moderate Hemophilia A

Summary

Sixteen patients with mild and moderate hemophilia were given Desmopressin (DDAVP) subcutaneously in the absence of any actual bleeding. The response to the drug – in terms of factor VIII coagulant activity rise – became apparent 15 min after the injection, reaching the maximal response after one hour (x̄ 3.2 times the baseline levels; SD 1.21). This response was not different from that elicited using the intravenous route in 18 hemophiliacs of comparable severity after the same time interval. No local or general side-effects were recorded after the subcutaneous administration of DDAVP. We therefore conclude that the subcutaneous route adds further evidence to the reliability of this alternative treatment in mild factor VIII deficiencies, thus making home treatment with this vasopressin analogue possible.

Keywords

DDAVP - Hemophilia A - Mild hemophilia - Subcutaneous DDAVP

• References

• 1 Mannucci PM, Ruggeri ZM, Pareti FI, Capitanio A. l-Deamino-8-D-arginine vasopressin: a new pharmacological approach to the management of haemophilia and von Willebrand’s disease. Lancet 1977; 01: 869-872
• 2 Mannucci PM, Ruggeri ZM, Pareti FI, Capitanio A. DDAVP in Haemophilia. Lancet 1977; 02: 1171-1172
• 3 Ockelford PA, Chandrasekhara Menon M, Berry EW. Clinical experience with arginine vasopressin (DDAVP) in von Willebrand’s disease and mild haemophilia. NZ med J 1980; 672: 375-378
• 4 Warrier I, Lusher JM. DDAVP: a useful alternative to blood components in moderate hemophilia A and von Willebrand’ disease. J Pediatr 1983; 102: 228-233
• 5 Mariani G, Ciavarella N, Mazzucconi MG, Antoncecchi S, Solinas S, Ranieri P, Pettini P, Agrestini F, Mandelli F. Evaluation of the effectiveness of DDAVP in surgery and bleeding episodes in haemophilia and von Willebrand’s disease. A study of 43 patients. Clin Lab Haematol 1984; 06: 229-238
• 6 Streit A, Furlan M, Beck EA. Home self-care with intranasally administered DDAVP in mild hemophilia and von Willebrand's disease.Proc XVI Int Congr World Fed Hemophilia. Rio de Janeiro Aug 1984; 36 (Abstract)
• 7 Köhler M, Hellstern P, Reiter B, von Blohn G, Wenzel E. The subcutaneous administration of the vasopressin analogue 1-Desamino-8-D-Arginine Vasopressin in Patients with von Willebrand’s disease and haemophilia. Klin Wochenschr 1984; 62: 543-548
• 8 Langdell RD, Wagner RH, Brinkhous KM. Effect of antihemophilic factor on one stage clotting tests. J Lab Clin Med 1953; 41: 637-644
• 9 Kasper CK, Kipnis SA. Hepatitis and clotting factor concentrates. JAMA 1972; 221: 510-522
• 10 Craske J, Dilling N, Stern D. An outbreak of hepatitis associated with intravenous injection of factor VIII concentrates. Lancet 1975; 02: 221-223
• 11 Gerety RJ, Barker LT. Viral antigens and antibodies in Hemophiliacs. A review. In: Fratantoni JC, Aronson DL. (eds.). Unsolved therapeutic problems in hemophilia, p 51-56 DHEW publication No (NIH) 77-1089. 1976
• 12 Norkrans G, Widell A, Teger-Nilsson AC, Kjellman H, Frosner G, Iwarson S. Acute hepatitis non-A, non-B following administration of factor VIII concentrates. Vox Sang 1981; 41: 129-133
• 13 Colombo M, Rumi MG. Liver Disease and Pathology in Haemophilia. Scand J Haematol 1984; (Suppl. 40) 33: 341-348