1-DEAMINO-8-D-ARGININE VASOPRESSIN

A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE

P. M. Mannucci, F. I. Pareti, Z. M. Ruggeri, Anna Capitanio

Research output: Contribution to journalArticle

443 Citations (Scopus)

Abstract

1-Deamino-8-D-arginine vasopressin (D.D.A.V.P.) infusion causes a marked incease in factor-VIII (antihæmophilic-factor)-related properties in patients with moderate and mild hæmophilia and von Willebrand's disease (vWd). The possibility was therefore evaluated that such an autologous factor-VIII response might be hæmostatically effective, allowing patients to undergo surgery without plasma concentrates. 0·3 μg/kg of D.D.A.V.P. given before dental surgery and repeated in the early postoperative period was followed by a two to three fold rise in factor-VIII coagulant activity (VIII C.A.) in four patients with moderate and mild hæmophilia. In two, there was no abnormal bleeding after dental extraction, whereas plasma concentrates were necessary to control oozing from the sockets in the remaining two patients. A higher D.D.A.V.P. dosage (0·4-0·5 μg/kg) in patients with higher starting VIII C.A. (9% or more) was followed by a more marked response (four to six fold). VIII C.A. levels up to 100% of average normal were achieved and dental extractions and major surgery (such as cholecystectomy, thoracotomy, and two tonsillectomies) were carried out successfully in six patients with mild hæmophilia and in two with vWd. The mean half-life of autologous VIII C.A. was 9·4 h (range 7·5-11·6). Plasma and urine osmolality showed no consistent variation after drug administration. Thus D.D.A.V.P. appears a promising pharmacological alternative to plasma concentrates in the management of some patients with hæmophilia and vWd.

Original languageEnglish
Pages (from-to)869-872
Number of pages4
JournalLancet
Volume309
Issue number8017
DOIs
Publication statusPublished - Apr 23 1977

Fingerprint

von Willebrand Diseases
Deamino Arginine Vasopressin
Hemophilia A
Coagulants
Pharmacology
Factor VIII
Tooth Extraction
Tonsillectomy
Cholecystectomy
Thoracotomy
Postoperative Period
Osmolar Concentration
Half-Life
Tooth
Urine
Hemorrhage
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

1-DEAMINO-8-D-ARGININE VASOPRESSIN : A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE. / Mannucci, P. M.; Pareti, F. I.; Ruggeri, Z. M.; Capitanio, Anna.

In: Lancet, Vol. 309, No. 8017, 23.04.1977, p. 869-872.

Research output: Contribution to journalArticle

Mannucci, P. M. ; Pareti, F. I. ; Ruggeri, Z. M. ; Capitanio, Anna. / 1-DEAMINO-8-D-ARGININE VASOPRESSIN : A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE. In: Lancet. 1977 ; Vol. 309, No. 8017. pp. 869-872.
@article{48da09f4345b451e86501edad3f46c24,
title = "1-DEAMINO-8-D-ARGININE VASOPRESSIN: A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE",
abstract = "1-Deamino-8-D-arginine vasopressin (D.D.A.V.P.) infusion causes a marked incease in factor-VIII (antih{\ae}mophilic-factor)-related properties in patients with moderate and mild h{\ae}mophilia and von Willebrand's disease (vWd). The possibility was therefore evaluated that such an autologous factor-VIII response might be h{\ae}mostatically effective, allowing patients to undergo surgery without plasma concentrates. 0·3 μg/kg of D.D.A.V.P. given before dental surgery and repeated in the early postoperative period was followed by a two to three fold rise in factor-VIII coagulant activity (VIII C.A.) in four patients with moderate and mild h{\ae}mophilia. In two, there was no abnormal bleeding after dental extraction, whereas plasma concentrates were necessary to control oozing from the sockets in the remaining two patients. A higher D.D.A.V.P. dosage (0·4-0·5 μg/kg) in patients with higher starting VIII C.A. (9{\%} or more) was followed by a more marked response (four to six fold). VIII C.A. levels up to 100{\%} of average normal were achieved and dental extractions and major surgery (such as cholecystectomy, thoracotomy, and two tonsillectomies) were carried out successfully in six patients with mild h{\ae}mophilia and in two with vWd. The mean half-life of autologous VIII C.A. was 9·4 h (range 7·5-11·6). Plasma and urine osmolality showed no consistent variation after drug administration. Thus D.D.A.V.P. appears a promising pharmacological alternative to plasma concentrates in the management of some patients with h{\ae}mophilia and vWd.",
author = "Mannucci, {P. M.} and Pareti, {F. I.} and Ruggeri, {Z. M.} and Anna Capitanio",
year = "1977",
month = "4",
day = "23",
doi = "10.1016/S0140-6736(77)91197-7",
language = "English",
volume = "309",
pages = "869--872",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Lancet Publishing Group",
number = "8017",

}

TY - JOUR

T1 - 1-DEAMINO-8-D-ARGININE VASOPRESSIN

T2 - A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE

AU - Mannucci, P. M.

AU - Pareti, F. I.

AU - Ruggeri, Z. M.

AU - Capitanio, Anna

PY - 1977/4/23

Y1 - 1977/4/23

N2 - 1-Deamino-8-D-arginine vasopressin (D.D.A.V.P.) infusion causes a marked incease in factor-VIII (antihæmophilic-factor)-related properties in patients with moderate and mild hæmophilia and von Willebrand's disease (vWd). The possibility was therefore evaluated that such an autologous factor-VIII response might be hæmostatically effective, allowing patients to undergo surgery without plasma concentrates. 0·3 μg/kg of D.D.A.V.P. given before dental surgery and repeated in the early postoperative period was followed by a two to three fold rise in factor-VIII coagulant activity (VIII C.A.) in four patients with moderate and mild hæmophilia. In two, there was no abnormal bleeding after dental extraction, whereas plasma concentrates were necessary to control oozing from the sockets in the remaining two patients. A higher D.D.A.V.P. dosage (0·4-0·5 μg/kg) in patients with higher starting VIII C.A. (9% or more) was followed by a more marked response (four to six fold). VIII C.A. levels up to 100% of average normal were achieved and dental extractions and major surgery (such as cholecystectomy, thoracotomy, and two tonsillectomies) were carried out successfully in six patients with mild hæmophilia and in two with vWd. The mean half-life of autologous VIII C.A. was 9·4 h (range 7·5-11·6). Plasma and urine osmolality showed no consistent variation after drug administration. Thus D.D.A.V.P. appears a promising pharmacological alternative to plasma concentrates in the management of some patients with hæmophilia and vWd.

AB - 1-Deamino-8-D-arginine vasopressin (D.D.A.V.P.) infusion causes a marked incease in factor-VIII (antihæmophilic-factor)-related properties in patients with moderate and mild hæmophilia and von Willebrand's disease (vWd). The possibility was therefore evaluated that such an autologous factor-VIII response might be hæmostatically effective, allowing patients to undergo surgery without plasma concentrates. 0·3 μg/kg of D.D.A.V.P. given before dental surgery and repeated in the early postoperative period was followed by a two to three fold rise in factor-VIII coagulant activity (VIII C.A.) in four patients with moderate and mild hæmophilia. In two, there was no abnormal bleeding after dental extraction, whereas plasma concentrates were necessary to control oozing from the sockets in the remaining two patients. A higher D.D.A.V.P. dosage (0·4-0·5 μg/kg) in patients with higher starting VIII C.A. (9% or more) was followed by a more marked response (four to six fold). VIII C.A. levels up to 100% of average normal were achieved and dental extractions and major surgery (such as cholecystectomy, thoracotomy, and two tonsillectomies) were carried out successfully in six patients with mild hæmophilia and in two with vWd. The mean half-life of autologous VIII C.A. was 9·4 h (range 7·5-11·6). Plasma and urine osmolality showed no consistent variation after drug administration. Thus D.D.A.V.P. appears a promising pharmacological alternative to plasma concentrates in the management of some patients with hæmophilia and vWd.

UR - http://www.scopus.com/inward/record.url?scp=0017336844&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017336844&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(77)91197-7

DO - 10.1016/S0140-6736(77)91197-7

M3 - Article

VL - 309

SP - 869

EP - 872

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 8017

ER -