Clinical use of Haemate • P in inherited von Willebrand's disease: A cohort study on 100 Italian patients

Augusto B. Federici, Giancarlo Castaman, Massimo Franchini, Massimo Morfini, Ezio Zanon, Antonio Coppola, Annarita Tagliaferri, Elio Boeri, Maria Gabriella Mazzucconi, Gina Rossetti, Pier Mannuccio Mannucci

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Plasma-derived concentrates containing von Willebrand factor and factor VIII (VWF/FVIII concentrates) are the mainstay of treatment of patients with inherited von Willebrand's disease (VWD) who are unresponsive or have a contraindication to desmopressin (DDAVP) therapy. Only a few clinical studies are available on the use of these VWF/FVIII concentrates in large numbers of cases and within the same country. The aim of our study was to collect retrospective data on the efficacy and safety of Haemate® P (CSL Behring, Marburg, Germany) in a large cohort of well-characterized VWD patients after the introduction of the guidelines for VWD management in Italy. Design and Methods: A retrospective survey of data records was organized among ten Italian Hemophilia Centers in order to retrieve information on the clinical use of Haemate® P. Data on 100 VWD patients (44 males and 56 females, median age 41.5, range 2-87 years) were available relating to the period from January 2002 to December 2004. All patients were diagnosed according to the criteria proposed by the Italian guidelines for VWD management. Results: Of the 100 VWD patients enrolled, 23 had type 1 VWD, 40 had type 2 (2A=7, 2B=11, 2M=9, 2M Vicenza=13) and 37 had type 3. Seventy-one percent were severely affected, as shown by VWF:RCo levels 6 IU of VWF:RCo through 366 infusions of Haemate® P The median daily dose was 80 (range, 27-146) VWRRCo IU/kg, with clinical responses rated as excellent/good in 97% of patients. Twelve patients (type 1=1, type 2B=1, type 2M Vicenza=1, type 3=9, with a median age of 34.5, range 11-71 years) also underwent 17 long-term secondary prophylaxis regimens to prevent recurrent bleeding at the same site (47% in the gastrointestinal tract, 35% in joints). During the 4,358 days of prophylaxis, the patients received 1,424 infusions of Haemate® P, given three times (53%) or twice (47%) a week, with clinical responses rated as excellent/good in 100%. No serious adverse events, including thrombosis, were reported in the 370 evaluated treatments. Interpretation and Conclusions: Based on this retrospective study conducted in a large cohort of Italian patients (n=100) and covering a long period of observation (36 months), Haemate® P was shown to be effective and safe for the clinical management of patients with VWD, whether given on demand or as prophylaxis.

Original languageEnglish
Pages (from-to)944-951
Number of pages8
JournalHaematologica
Volume92
Issue number7
DOIs
Publication statusPublished - Jul 2007

Keywords

  • Bleeding
  • Haemate® P/Humate-P®
  • Ristocetin co-factor unit
  • Secondary long-term prophylaxis
  • Surgery
  • Von Willebrand's disease

ASJC Scopus subject areas

  • Hematology

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    Federici, A. B., Castaman, G., Franchini, M., Morfini, M., Zanon, E., Coppola, A., Tagliaferri, A., Boeri, E., Mazzucconi, M. G., Rossetti, G., & Mannucci, P. M. (2007). Clinical use of Haemate • P in inherited von Willebrand's disease: A cohort study on 100 Italian patients. Haematologica, 92(7), 944-951. https://doi.org/10.3324/haematol.11124