How are VWF Levels Monitored During Treatment?
How are VWF Levels Monitored During Treatment?
Why It Matters
Monitoring von Willebrand factor (VWF) levels is crucial when treating VWD, especially during major bleeding episodes. This article explains the importance and process of monitoring these levels.
Contents
- The Importance of Monitoring VWF Levels
- Methods of Monitoring VWF Activity
- Challenges in Monitoring
The Importance of Monitoring VWF Levels
VWF levels must be closely monitored during treatment to ensure effective clot formation and prevent excessive bleeding. Regular monitoring helps adjust treatment dosages and schedules, ensuring that patients receive the optimal amount to control bleeding. Without proper monitoring, patients risk either insufficient treatment or complications from excess VWF.
Methods of Monitoring VWF Activity
VWF activity is typically measured using assays like VWF:RCo, which determines the factor's ability to bind to platelets. These tests are conducted daily during treatment, with initial measurements taken 6 to 12 hours after the first infusion. Additional measurements are taken before subsequent infusions to check trough levels and adjust dosages as needed.
Challenges in Monitoring
Not all lab tests can predict the hemostatic effect of VWF concentrates accurately. Clinicians must rely on both lab results and clinical observations to decide on treatment adjustments. Unexpected low responses may indicate inhibitor formation, necessitating higher doses or alternative treatments.
FAQs
Why monitor VWF levels during treatment?
Monitoring ensures effective clot formation and prevents complications.
How often are VWF levels checked?
Levels are checked daily and before each infusion.
What indicates an unexpected low VWF response?
It may indicate inhibitor formation, requiring treatment adjustments.
What assays are used to measure VWF activity?
Assays like VWF:RCo are commonly used.
The Bottom Line
Regular monitoring of VWF levels is vital for effective and safe treatment of VWD.
Additional References
- Sharma R, Flood VH. Advances in the diagnosis and treatment of Von Willebrand disease. Blood 2017; 130:2386.
- Gill JC, Castaman G, Windyga J, et al. Hemostatic efficacy, safety, and pharmacokinetics of a recombinant von Willebrand factor in severe von Willebrand disease. Blood 2015; 126:2038.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.