Treatment

Related information and links

Pathogen detection and inactivation of plasma products

 

PCR test is a molecular method that detects viruses in the blood. Traditional antibody tests detect the presence of antibodies that are being produced by the body in order to fight the infection.

An advantage of the PCR test is that there is no need to wait until antibodies are produced in the blood, which can take up to 20 days. The PCR test is so sensitive that it can trace single virus particles.

 

S/D treatment is a well-documented and validated chemical process that effectively inactivates lipid-enveloped viruses, such as HIV, hepatitis B and hepatitis C, but also previously unknown lipid-enveloped viruses. The lipid envelope is dissolved by the S/D treatment, thus rendering the virus unable to bind to cell receptors.

Octapharma was the first company to use the method on an industrial scale to inactivate viruses, as early as 1986.

 

 

 

 

 

 

Treatment

von Willebrand disease is a life-long illness that cannot be cured. However, today there are different alternatives for the effective treatment and prevention of bleedings. Which one is the most suitable depends mainly on the severity of the disease.

Mild and some forms of moderate von Willebrand disease

In milder forms of VWD bleeding, symptoms can often be treated with desmopressin — a synthetically produced drug. The effect of desmopressin varies from person to person and can lead to an increase in both VWF and coagulation factor VIII.

Another treatment alternative is to use a drug containing tranexamic acid. This substance prevents the blood from dissolving clots and is administered in the form of tablets, liquid or as an injection. Among other uses, it is considered to be effective in the management of bleedings in the nose, the mouth and the uterus. Drugs containing tranexamic acid can also be used locally — for example in the nose to stop nose bleeds or as a mouthwash for tooth extractions. Often desmopressin and tranexamic acid are used in combination. In minor bleedings tranexamic acid alone can be sufficient.

 

Severe and some forms of moderate von Willebrand disease

Severe and moderate forms of VWD are best treated with so-called factor concentrates. These are derived from blood plasma and contain both VWF and coagulation factor VIII. They replace the proteins that are missing in the blood. As with other proteins, the coagulation factors are broken down naturally in the body and, therefore, must be replaced continually.

Modern von Willebrand concentrates undergo very careful monitoring during the entire production process. First, the health of blood donors is examined in order to ensure that they are suitable donors. Then a molecular testing method — PCR testing — is applied, which detects potential infection with hepatitis A, hepatitis B, hepatitis C, parvo virus or HIV.

The concentrate is then virus inactivated as a third security measure. The factor concentrate undergoes several virus-inactivation steps including, for example, a well-established chemical method (the so-called solvent-detergent treatment, S/D  treatment) which inactivates potential lipid-enveloped viruses.

Another virus inactivation method is heat treatment that inactivates potential non-enveloped viruses in the plasma. These two methods effectively inactivate all potential remaining or unknown viruses. Finally, the product undergoes an ultimate quality control before reaching the pharmacy. From a viral safety perspective, factor concentrates are now considered to be safe drugs, thanks to these controls and state-of-the-art production processes, for example as recommended by the World Federation of Hemophilia (WFH).

Today, due to the thorough production process and the well-preserved physiological characteristics of modern factor concentrates, it is possible to minimise the risk of adverse events. Defined half-lives and standardised contents of the two therapeutic proteins — factor VIII and von Willebrand factor — minimise the risk of potential overdosing. In addition, keeping the amount of albumin to a minimum is another way of reducing the content of non-therapeutic proteins which, in turn, could cause adverse events.

 

Page updated: 2016-06-17