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ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease

Connell, NT; Flood, VH; Brignardello-Petersen, R; Abdul-Kadir, R; Arapshian, A; Couper, S; Grow, JM; ... Mustafa, RA; + view all (2021) ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease. Blood Advances , 5 (1) pp. 301-325. 10.1182/bloodadvances.2020003264. Green open access

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Abstract

Background: von Willebrand disease (VWD) is a common inherited bleeding disorder. Significant variability exists in management options offered to patients. / Objective: These evidence-based guidelines from the American Society of Hematology (ASH), the International Society on Thrombosis and Haemostasis (ISTH), the National Hemophilia Foundation (NHF), and the World Federation of Hemophilia (WFH) are intended to support patients, clinicians, and health care professionals in their decisions about management of VWD. / Methods: ASH, ISTH, NHF, and WFH formed a multidisciplinary guideline panel. Three patient representatives were included. The panel was balanced to minimize potential bias from conflicts of interest. The University of Kansas Outcomes and Implementation Research Unit and the McMaster Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process, including performing and updating systematic evidence reviews (through November 2019). The panel prioritized clinical questions and outcomes according to their importance to clinicians and patients. The panel used the GRADE approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. / Results: The panel agreed on 12 recommendations and outlined future research priorities. / Conclusions: These guidelines make key recommendations regarding prophylaxis for frequent recurrent bleeding, desmopressin trials to determine therapy, use of antiplatelet agents and anticoagulant therapy, target VWF and factor VIII activity levels for major surgery, strategies to reduce bleeding during minor surgery or invasive procedures, management options for heavy menstrual bleeding, management of VWD in the context of neuraxial anesthesia during labor and delivery, and management in the postpartum setting.

Type: Article
Title: ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1182/bloodadvances.2020003264
Publisher version: https://doi.org/10.1182/bloodadvances.2020003264
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Clinical Guidelines, Thrombosis and Hemostasis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
URI: https://discovery.ucl.ac.uk/id/eprint/10119839
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