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Groups Jointly Issue Guidelines for Von Willebrand Disease

MONDAY, Jan. 25, 2021 -- Recommendations are presented for the diagnosis and management of von Willebrand disease (VWD) in two clinical guidelines issued by the American Society of Hematology, International Society on Thrombosis and Haemostasis, National Hemophilia Foundation, and World Federation of Hemophilia and published online Jan. 12 in Blood Advances.

Paula D. James, M.D., from Queen's University in Kingston, Ontario, Canada, and colleagues developed evidence-based guidelines for the diagnosis of VWD and agreed on 11 recommendations. These recommendations include the role of bleeding assessment tools for examining patients suspected of VWD; diagnostic assays and laboratory cutoffs for VWD; an approach for type 1 VWD patients with normalized levels over time; and the role of genetic testing versus phenotypic assays for types 2B and 2N.

Nathan T. Connell, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues developed evidence-based guidelines for the management of VWD and agreed on 12 recommendations. The recommendations included use of prophylaxis for frequent recurrent bleeding, desmopressin trials to determine appropriate therapy, and use of antiplatelet agents or anticoagulant therapy. For patients undergoing major surgery, target von Willebrand factor and factor VIII activity levels are suggested; the guideline also addresses strategies to reduce bleeding during minor surgery or invasive procedures. Management options for heavy menstrual bleeding, disease management in the context of neuraxial anesthesia during labor and delivery, and management in the postpartum setting are also discussed.

"These guidelines are an extremely important step in our quest to address the difficulties individuals go through to obtain an accurate, timely diagnosis, and appropriate treatment," Leonard Valentino, M.D., president and chief executive officer of the National Hemophilia Foundation, said in a statement.

Guidelines: Diagnosis

Guidelines: Management

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