Safety and efficacy of continuous infusion of a combined factor VIII - vonWillebrand factor (vWF) concentrate (Haemate-P (TM)) in patients with von Willebrand disease

We studied the safety and efficacy of treatment with continuous infusion of a von Willebrand factor (VWF) concentrate Haemate-P in patients with von W illebrand disease (vWD). Three patients with mild and 5 patients with sever e forms of vWD, were treated with continuous infusion of Haemate-P by minip ump. The indications for treatment were: to prevent bleeding during 9 surgi cal procedures or 1 vaginal delivery in 6 patients and to treat 2 bleeding episodes in 2 patients. The patients were monitored daily for factor VIII ( FVIII:C) and ristocetin cofactor (VWF:RCo) levels and the infusion rate was adjusted to maintain the desired therapeutic level of VWF:RCo. The treatme nt was effective in preventing surgical bleeding and controlling bleeding e pisodes, All factor VIII:C and most of the VWF:RCo levels measured during t he study period were above the target therapeutic levels. A significant dec rease in clearance of FVIII:C and vWF:RCo was observed over the treatment p eriod. Haemate-P consumption averaged 24.3 +/- 7.9 VWF:RCo U/kg/day which i s approximately half the expected dose had intermittent bolus injections be en used. We suggest that continuous Haemate-P infusion is superior to inter mittent bolus injections for the treatment of vWD patients by virtue of its efficiency, simplicity and considerable savings.