Evidence map›Paper›PMID 39854691›Full record

SynthesisBlood2025

DDAVP response and its determinants in bleeding disorders: a systematic review and meta-analysis.

Sebastiaan Laan, Jessica Del Castillo Alferez, Suzanne Cannegieter, Karin Fijnvandraat, Marieke Kruip, Saskia le Cessie, Ruben Bierings, Jeroen Eikenboom, Iris van Moort

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Blood, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Buckle up! Managing surgery in patients with bleeding disorder of unknown cause.Hematology. American Society of Hematology. Education Program · 2025
    Article
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sebastiaan LaanDepartment of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden Universiteit Medical Centre, Leiden, The Netherlands.ORCID 0000-0001-9206-8712
Jessica Del Castillo AlferezDepartment of Molecular Hemostasis, Sanquin Research, Amsterdam, The Netherlands.ORCID 0000-0002-2305-0743
Suzanne CannegieterDepartment of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden Universiteit Medical Centre, Leiden, The Netherlands.ORCID 0000-0003-4707-2303
Karin FijnvandraatDepartment of Molecular Hemostasis, Sanquin Research, Amsterdam, The Netherlands.ORCID 0000-0003-0904-4360
Marieke KruipDepartment of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0002-0265-4871
Saskia le CessieDepartment of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
Ruben BieringsDepartment of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0002-1205-9689
Jeroen EikenboomDepartment of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden Universiteit Medical Centre, Leiden, The Netherlands.
Iris van MoortDepartment of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0002-0248-4710

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractDesmopressin (1-desamino-8-d-arginine vasopressin [DDAVP]) can be used to prevent or stop bleeding. However, large interindividual variability is observed in DDAVP response and determinants are largely unknown. In this systematic review and meta-analysis, we aimed to identify the response to DDAVP and the factors that determine DDAVP response in patients. We included studies with patients with any bleeding disorder receiving DDAVP. First and second screening round and risk of bias assessment were performed by independent reviewers. The main outcome was proportion of patients with complete (factor level >50 U/dL) or partial (30-50 U/dL) response to DDAVP. Determinants of response including disease type, age, sex, von Willebrand factor (VWF) and factor VIII (FVIII) mutations, and baseline factor levels were investigated. In total, 591 articles were found and 103 were included. Of these, 71 articles (1772 patients) were suitable for the study's definition of response. Meta-analysis showed a pooled response proportion of 0.71 (0.64; 0.78) and a significant difference in response between disease subtypes. For hemophilia A, baseline FVIII activity (FVIII:C) was a borderline significant determinant of response. In patients with von Willebrand disease (VWD) type 1, VWF antigen (VWF:Ag), VWF activity, and FVIII:C were significant determinants. A large variation in response was observed for specific mutations in VWF and FVIII. Response to DDAVP varied between disease subtypes and was largely determined by the baseline levels of FVIII:C for hemophilia A and VWF:Ag for VWD. Our findings highlight the significant differences in response and emphasize the need for a standardized response definition and further research into response mechanisms.

Indexed as

Deamino Arginine VasopressinHemorrhagic DisordersHemostaticsFactor VIIIHemophilia AHumansvon Willebrand Diseasesvon Willebrand FactorDeamino Arginine VasopressinFactor VIIIHemostaticsvon Willebrand Factor

Identifiers

PMID39854691
PMCPMC12060165

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.