From the Research
DDAVP does not improve factor XI levels in patients with factor XI deficiency, as evidenced by the most recent and highest quality study available 1. The use of desmopressin (DDAVP) in patients with factor XI deficiency has been explored in several studies, but the most recent and highest quality study found that DDAVP did not produce a clinically significant increase in factor XI levels 1. This study assessed the response of factor XI coagulant activity and antigen to DDAVP in 33 individuals with von Willebrand disease or mild hemophilia A, and found that there was no significant increase in factor XI levels after administration of DDAVP.
Some older studies have suggested that DDAVP may be useful in patients with mild factor XI deficiency, particularly for preventing bleeding during surgical procedures 2. However, these studies were small and had limited follow-up, and the results have not been consistently replicated in larger, more recent studies.
In terms of dosing, DDAVP is typically administered at a dose of 0.3 mcg/kg intravenously or as a 300 mcg intranasal spray for adults. However, given the lack of evidence supporting its use in patients with factor XI deficiency, it is not recommended as a treatment option for this condition.
Instead, other treatments such as fresh frozen plasma or factor XI concentrates may be necessary to manage bleeding in patients with factor XI deficiency, particularly in cases of severe deficiency or major surgery 3. Patients should be monitored for potential side effects of these treatments, including fluid retention, hyponatremia, and thrombosis.
Key points to consider:
- DDAVP does not improve factor XI levels in patients with factor XI deficiency 1
- Other treatments such as fresh frozen plasma or factor XI concentrates may be necessary to manage bleeding in patients with factor XI deficiency 3
- Patients should be monitored for potential side effects of these treatments, including fluid retention, hyponatremia, and thrombosis
- The use of DDAVP in patients with factor XI deficiency should be approached with caution, given the limited evidence supporting its effectiveness 4