RGD Reference Report - Patterns of development of tachyphylaxis in patients with haemophilia and von Willebrand disease after repeated doses of desmopressin (DDAVP). - Rat Genome Database

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Patterns of development of tachyphylaxis in patients with haemophilia and von Willebrand disease after repeated doses of desmopressin (DDAVP).

Authors: Mannucci, PM  Bettega, D  Cattaneo, M 
Citation: Mannucci PM, etal., Br J Haematol. 1992 Sep;82(1):87-93.
RGD ID: 11552591
Pubmed: PMID:1419807   (View Abstract at PubMed)

When patients with mild haemophilia or von Willebrand disease (vWD) are repeatedly treated with desmopressin (DDAVP) at relatively short time intervals, some of them may become less responsive or unresponsive. The development of tachyphylaxis would limit the usefulness of DDAVP in clinical management of these patients. On the other hand, tachyphylaxis is not consistent, and its patterns of development are unknown. The aim of this study was to evaluate in controlled conditions the occurrence of tachyphylaxis by giving intravenous DDAVP (0.3 microgram/kg) on four consecutive days to a selected group of patients with mild haemophilia A (n = 22) and type I vWD (n = 15). After each dose, we measured parameters known to change after DDAVP, i.e. factor VIII coagulant activity, bleeding time, von Willebrand factor antigen, ristocetin cofactor and tissue-type plasminogen activator antigen. We found that on average the responses obtained after the second dose of DDAVP were approximately 30% less than those obtained after the first, but were not further reduced after the third and fourth dose. At all time intervals after DDAVP, patients with vWD responded relatively better than patients with haemophilia, and there were fewer vWD patients who responded poorly or became unresponsive. In vWD patients there were no significant changes in the bleeding time responses and in blood pressure and heart rate. The clinical implications of these findings are that repeated doses of DDAVP can be given efficaciously to many patients (particularly to those with vWD), even though responses lower than those seen after the first dose should be expected.



RGD Manual Disease Annotations    Click to see Annotation Detail View

  
Object SymbolSpeciesTermQualifierEvidenceWithNotesSourceOriginal Reference(s)
PLATHumanfactor VIII deficiency treatmentIDA  RGD 
PlatRatfactor VIII deficiency treatmentISOPLAT (Homo sapiens) RGD 
PlatMousefactor VIII deficiency treatmentISOPLAT (Homo sapiens) RGD 
PLATHumanvon Willebrand's disease 1 treatmentIDA  RGD 
PlatRatvon Willebrand's disease 1 treatmentISOPLAT (Homo sapiens) RGD 
PlatMousevon Willebrand's disease 1 treatmentISOPLAT (Homo sapiens) RGD 

Objects Annotated

Genes (Rattus norvegicus)
Plat  (plasminogen activator, tissue type)

Genes (Mus musculus)
Plat  (plasminogen activator, tissue)

Genes (Homo sapiens)
PLAT  (plasminogen activator, tissue type)


Additional Information