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Your treatment will depend on which type of VWD you have, your bleeding history, and any known bleeding patterns, so be sure you know which type/subtype you are and keep a log of known bleeds for reference. Treatment might involve factor replacement, hormonal therapy, or antifibrinolytics. Treatments and therapies are described below, divided by VWD type. Please note that VWF and FVIII replacement therapy can be in the same product, but each product has different ratios, so your hematologist will determine which product might work best for you.

VWD type 1

  • 1-desamino-8-D-arginine vasopressin (DDAVP)
  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

VWD type 2a

  • DDAVP
  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

VWD type 2b

  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics.

VWD type 2n

  • VWF replacement therapy
  • FVIII replacement therapy
  • Hormonal therapy
  • DDAVP (rarely works, but can be tried to find out)
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

VWD type 2m

  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

VWD type 3

  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

aVWS

  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

Pseudo-VWD

  • Hormonal therapy
  • VWF replacement therapy
  • FVIII replacement therapy
  • Topical bovine thrombin (topical and only for minor capillary bleeding)
  • Fibrin sealant (only effective in certain surgical situations)
  • Topical collagen sponges (useful for controlling bleeding wounds)
  • Antifibrinolytics (clot stabilization).

Inhibitors and VWD

Inhibitors are extremely rare in VWD, but they occur in approximately 5–10% of people with VWD type 3. If you’ve developed an inhibitor, your body has developed antibodies (specifically, alloantibodies) against VWF, causing your body to reject treatment VWF, either by getting rid of it or (rarely) causing an anaphylactic reaction. You may be at higher risk for an inhibitor if you have a family history of inhibitors. There are no standard laboratory methods for identifying and characterizing antibodies for VWF, possibly because it’s so rare. However, some effective treatments exist, including recombinant FVIII, bypassing agents, and immune tolerance.


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