Von Willebrand's Disease: Treatment Overview

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Treatment Overview

Von Willebrand's disease is a lifelong disease, so you may need treatment at different times in your life. Most people have mild cases. But the disease can change over the years to get gradually better or worse. If you have a mild case, you may need treatment only when you have a chance of bleeding, such as when you have an injury, are having surgery, or are about to give birth. At other times, you may have enough von Willebrand factor so that your blood clots normally. People with a severe form of von Willebrand's disease may need treatment more often.

Medicines to increase the von Willebrand factor in your blood and to prevent the breakdown of blood clots treat all types of von Willebrand's disease. But there is no cure for this disease.

Treatment for von Willebrand's disease may consist of:

• Desmopressin to help your body make more von Willebrand factor, to reduce blood loss during a woman's menstrual periods, and to help control bleeding episodes. Because the effects of this medicine can vary, your doctor will prescribe it on a trial basis to see how much it increases the amount of clotting factors in your blood and to monitor side effects.⁶ Desmopressin is not used to treat type 2b disease.⁷
• Therapies to replace the clotting factors in your blood. Replacement therapy injections (infusions) may be used with people who:
  • Do not respond to desmopressin.
  • Have type 2b von Willebrand's disease.
  • Have a rare and more severe form of von Willebrand's disease (type 3).
  If you have type 3 von Willebrand's disease, you may be taught to inject yourself with blood-clotting factors. If you can give yourself a shot as soon as a bleeding episode starts, you can avoid losing too much blood and prevent any permanent damage that could be caused by the bleeding.
• Antifibrinolytic agents that help prevent the breakdown of blood clots. Antifibrinolytic medicines can be used alone or in combination with desmopressin medicine or replacement therapy to treat mild bleeding. These medicines are sometimes used to prevent bleeding during surgery.
• Birth control pills (oral contraceptives) to help control heavy menstrual periods in women who have von Willebrand's disease.¹ Birth control pills contain forms of estrogen and progesterone that help reduce blood loss during a woman's period.
• Topical medicine to control very mild bleeding in the mouth or nose. Thrombin powder is a dry powder that you can apply directly on a wound to help it clot. It is especially useful during dental procedures.
• Avoiding medicines, such as aspirin, that can affect bleeding.

Your doctor may combine some of these treatments, depending on how the disease affects you.

Last updated:	November 29, 2006
Author:	Debby Golonka, MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Joseph O'Donnell, MD - Hematology/Oncology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC