Before engaging in physical activity, individuals with mild hemophilia A (HA) may administer intranasal desmopressin. However, Desmopressin is costly and may result in nausea, headaches, palpitations, and on rare occasions, seizures. Researcher’s team has previously seen a 2.3-fold rise in factor VIII activity (FVIII:C) in teenagers with mild HA following moderate-intensity aerobic exercise. For a study, they provided the key outcomes of a randomized study comparing intranasal desmopressin to a prescribed, moderate-intensity aerobic exercise program in young people with mild HA.
The main goal was to contrast the difference in FVIII:C brought on by these 2 therapies. Additionally, we looked at modifications in hemostatic characteristics brought on by their successive administration. The trial was carried out concurrently at Nationwide Children’s Hospital in the United States and the Hospital for Sick Children in Canada. Thirty-two male adolescents (mean age ± standard deviation: 16.1 ± 2.6 years) with moderate HA (mean baseline FVIII:C: 27.9%±18.4%) who met the trial’s eligibility criteria were randomly assigned to 1 of 4 study arms (desmopressin followed by exercise, desmopressin alone, exercise followed by desmopressin, and exercise alone). Blood tests were taken at the baseline and three additional time points.
For around 12 minutes, participants who were randomly assigned to exercise cycled on an ergometer, with the final 3 minutes being at 85% of their expected maximum heart rate. Desmopressin was dosed according to weight as usual. Exercise resulted in a mean 1.7-fold immediate rise in FVIII:C compared to desmopressin’s 1.9-fold (noninferiority, P =.04). Exercise only temporarily improved hemostatic measures, such as FVIII:C, as opposed to desmopressin, which led to longer-lasting benefits. At 75 and 135 minutes into the trial procedure, more than 60% of subjects who were randomly assigned to receive both exercise and desmopressin had normal (>50%) FVIII:C.
