A patient with anti-phospholipid syndrome undergoes fertility treatment because she had already suffered two miscarriages. During a laboratory examination at the beginning of pregnancy, Von Willebrand syndrome is also diagnosed. However, treating both conditions simultaneously is challenging.
* VEYVONDI® may be used only when therapy with desmopressin (DDAVP) alone is ineffective or contraindicated. Dosage and frequency must be determined on an individual basis depending on clinical judgment and based on patient weight, type and severity of bleeding episodes/surgical intervention, and based on monitoring of appropriate clinical and laboratory measurements. See also current technical information VEYVONDI® www.swissmedicinfo.ch
| Comment by Rosa Sonja Alesci, MD
|
Von Willebrand syndrome and anti-phospholipid syndrome often occur together. This is difficult in that the two conditions require contrasting treatments. Thus, anti-phospholipid syndrome is treated with heparin and ASA. However, ASA should be avoided in the presence of Von Willebrand syndrome. The situation is particularly difficult in pregnant women, as anti-phospholipid syndrome can lead to abortions and Von Willebrand syndrome to bleeding if left untreated. In the present case, therefore, the anti-phospholipid syndrome was initially treated with heparin alone and recombinant Von Willebrand factor (Veyvondi®) was administered simultaneously to minimize the patient’s bleeding. Due to the difficult situation, very frequent monitoring of the patient was necessary during this time in order to be able to react quickly and adjust the treatment if necessary. After six courses of treatment with Veyvondi® , the laboratory values had stabilized to such an extent that therapy for Von Willebrand syndrome could be stopped. Heparin treatment is currently continued and supplemented with ASA to further control the anti-phospholipid syndrome.Abbreviations
AK = antibody; aPTT = activated partial thromboplastin time; FVIII:C = factor VIII activity; Ig = immunoglobulin; PFA-100 = Platelet Function Analyzer 100; VWF:Ag = von Willebrand factor antigen; VWF:CBA = von Willebrand factor collagen binding activity; VWF:RCo = von Willebrand factor ristocetin cofactor activity.
C-APROM/CH//0761 05/2020
VEYVONDI ® Brief technical information
Z:
Active ingredient: Vonicogum alfa.
I:
Treatment of bleeding or surgery-related hemorrhage in the of–Willebrand–disease when therapy with desmopressin (DDAVP) alone is ineffective or contraindicated.
D:
Dosage and frequency must be individualized based on clinical judgment and based on patient weight, type and severity of bleeding episodes/surgical intervention, and based on monitoring of appropriate clinical and laboratory measurements; Intravenous administration. AI: Hypersensitivity to the active substance or any of the excipients. Known allergic reaction to mouse– or hamster proteins.
VM:
There are hypersensitivity– or allergic reactions occurred, which may progress to severe anaphylaxis. Monitor patients closely during infusion. Neutralizing antibodies can be formed against Von–Willebrand–Develop factor. There is a risk of thrombotic events.
SS:
Use only when clearly indicated.
UW:
From–Willebrand–Factor Inhibitors, Hypersensitivity– or allergic reactions, tremor, hypertension, vertigo, deep vein thrombosis, ECG changes.
IA:
There are no known interactions. P: Lyophilisate with 650 I.U. or 1,300 I.U. with 5 ml (resp. 10 ml for 1,300 I.E.) water for injection. Levy category B. Z: Takeda Pharma AG, 8152 Opfikon. You can find detailed information at www.swissmedicinfo.ch
