A Study of the Effect of Ethamsylate (Dicynene) on the Bleeding Time, von Willebrand Factor Level and Fibrinolysis in Patients with von Willebrand’s Disease

Summary

Nine patients with clinically moderate or severe Type I von Willebrand’s disease were treated for 2 weeks with ethamsylate (2 g/day in four equal doses) and with a matched placebo in a randomised double-blind trial. Template bleeding time, von Willebrand factor activity (ristocetin co-factor) and antigen, euglobulin lysis time and type I tissue plasminogen activator inhibitor were determined before and at the end of each treatment period. None of these parameters showed any significant change attributable to ethamsylate. Thus, despite the fact that five patients thought subjectively that their bleeding symptoms improved during ethamsylate treatment compared to only one while on placebo, we obtained no evidence that the drug was of benefit to patients with von Willebrand’s disease

Keywords

Bleeding time - von Willebrand factor - Fibrinolysis

• References

• 1 Canal P. Ensayo comparativo de la accion cyclonamina y un placebo. Anales del Hospital de la Santa Cruz y San Pablo 1964; 24: 253-257
• 2 Louis J, Paulus JM. Essai d’un nouvel haemostatique: la Dicynone. Rev Med Liége 1967; 22: 649-651
• 3 Vinazzer H. Clinical and experimental studies on the action of ethamsylate on haemostasis and on platelet function. Thromb Res 1901; 19: 783-991
• 4 Rennie JM, Doyle J, Cooke RW I. Ethamsylate reduces immunoreactive prostacyclin metabolite in low birthweight infants with respiratory distress syndrome. Early Human Dev 1986; 14: 239-244
• 5 Harrison RF, Campbell S. A double-blind trial of ethamsylate in the treatment of primary and intra-uterine device menorrhagia. Lancet 1976; 2: 283-285
• 6 Kovacs L, Annus J. Effectiveness of ethamsylate in intrauterine device menorrhagia. Gynecol Obstet Invest 1978; 9: 161-165
• 7 Morgan ME I, Benson JW T, Cooke RW I. Ethamsylate reduces the incidence of periventricular haemorrhage in very low birthweight babies. Lancet 1981; 2: 830-831
• 8 Hutton RA, Wickham EA, Reed JV, Tuddenham EG D. Studies on the action of ethamsylate (Dicynene) on haemostasis. Thromb Haemostas 1986; 56: 6-8
• 9 Kumar R, Ansell JE, Canoso RT, Deykin D. Clinical trial of a new bleeding time device. Am J Clin Pathol 1978; 70: 692-695
• 10 Laurell CB. Quantitative investigation of proteins by electrophoresis in agarose gel containing antibodies. Analyt Biochem 1966; 15: 45-52
• 11 Weiss HJ, Hoyer LW, Rickies FR, Varma A, Rogers J. Quantitative assay of a plasma factor deficient in von Willebrand’s disease that is necessary for platelet aggregation. Relationship to factor VIII procoagulant activity and antigen content. J Clin Invest 1973 52. 2708-2716
• 12 Chmielewska J, Wiman B. Determination of tissue plasminogen activator and its “fast” inhibitor in plasma. Clin Chem 1986; 32: 482-485