Reflections on the importance of factor VIII and Von Willebrand factor pharmacokinetics in the safety and efficacy of current Von Willebrand factor concentrates




Ramon Salvado, Serviço de Imuno-Hemoterapia, Centro de Referência de Coagulopatias Congénitas, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Ramiro J. Núñez-Vázquez, Sección de Trombosis y Hemostasia, Hospital Universitario Virgen del Rocío, Sevilla, España
Manuel Rodríguez-López, Servicio de Hematología y Hemoterapia, Hospital Universitario Álvaro Cunqueiro, EOXI Vigo, Vigo, Pontevedra, España


Prophylaxis in Von Willebrand disease is addressed, focusing on the composition and efficacy of Von Willebrand factor concentrates. Three products with different characteristics in terms of their origin and composition (Veyvondi®, Wilate®, and Wilfact®) are compared, highlighting their differences in weekly consumption, infusions and thrombotic events. The results indicate that Wilate® has a lower weekly intake and comparable efficacy in reducing bleeding. The accumulation of factor VIII and its relationship with thrombotic risk are discussed, underlining the importance of precise dosing to maximize efficacy and minimize safety and economic risks.



Keywords: Von Willebrand disease. Prophylaxis. FVIII/VWF ratio. Randomized controlled trials. Thrombin generation.




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