VWD therapeutic management
| VWD treatment considerations . | . |
|---|---|
| Is desmopressin likely to be effective? | • Baseline VWF level >10% |
| • Conduct desmopressin trial (IV, SC, IN) | |
| • Test VWF:Ag, VWF:RCo, and FVIII:C levels at 1, 2, and 4 hours | |
| • Positive response both FVIII and VWF > 50% after administration | |
| Addition of adjunctive therapies | • Antifibrinolytics |
| • For menorrhagia: oral contraceptive or levonorgestrel-releasing IUD | |
| VWF concentrates | • If desmopressin response is inadequate |
| • If desmopressin is required for several consecutive days | |
| • Dosing/product considerations | |
| VWF/FVIII ratio | |
| VWF multimer profile | |
| Dosing by VWF:RCo or FVIII:C | |
| Potential for prophylactic schedule | |
| Rare development of VWF alloantibodies |
| VWD treatment considerations . | . |
|---|---|
| Is desmopressin likely to be effective? | • Baseline VWF level >10% |
| • Conduct desmopressin trial (IV, SC, IN) | |
| • Test VWF:Ag, VWF:RCo, and FVIII:C levels at 1, 2, and 4 hours | |
| • Positive response both FVIII and VWF > 50% after administration | |
| Addition of adjunctive therapies | • Antifibrinolytics |
| • For menorrhagia: oral contraceptive or levonorgestrel-releasing IUD | |
| VWF concentrates | • If desmopressin response is inadequate |
| • If desmopressin is required for several consecutive days | |
| • Dosing/product considerations | |
| VWF/FVIII ratio | |
| VWF multimer profile | |
| Dosing by VWF:RCo or FVIII:C | |
| Potential for prophylactic schedule | |
| Rare development of VWF alloantibodies |