Case 360°™ Module #2: New Developments in the Treatment and Therapeutic Monitoring of VWD

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Release Date: March 29, 2018
Expiration Date: March 29, 2019
Estimated Time to Complete Activity:
0.75 hours
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Target Audience
This activity has been designed to meet the educational needs of hematologists, oncologists, pathologists, pharmacists, hematology/oncology nurses, advanced practice registered nurses, internists, their support staff, and other healthcare professionals who are interested in the management of patients with von Willebrand disease (VWD).

Statement of Need/Program Overview
Von Willebrand disease is the most common hereditary bleeding disorder, yet its diagnosis and management can be complex. There are 6 different types of VWD, each having unique clinical and laboratory characteristics. Accurate diagnosis of inherited or acquired VWD is required to guide treatment decisions, but diagnosis can be challenging, and currently there are no standard diagnostic algorithms. Molecular analyses can aid in certain cases, but clinicians usually must rely on laboratory diagnosis, clinical characteristics, and patient family history, all of which can vary and/or be subject to interpretation.

Standard therapy for VWD includes treatment with desmopressin (DDAVP) or plasma concentrate, with the specific therapy dictated according to VWD type and severity. Moreover, patients must be tested up front for their initial response to DDAVP prior to starting therapy, and there are differences between types of plasma concentrates, so clinicians should be familiar with treatment guidelines and differences in products.

In addition to these standard therapies, new treatments continue to be developed. The recent approval of recombinant von Willebrand factor (VWF) increases treatment options, but practitioners must know for which patients this product can be used, dosing and frequency, and how to accurately monitor factor levels. Continued development of recombinant VWF is likely to result in the availability of extended half-life factors, as seen with hemophilia. Awareness of these developments and ongoing clinical trials for eligible patients is necessary for practitioners who care for patients with VWD.

Educational Objectives
After participating in this activity, participants should be better able to:

  • Explain current management options for inherited VWD
  • Discuss laboratory monitoring for factor replacement therapy
  • Manage acute bleeding, hemostatic challenges (eg, surgery) and prophylaxis in patients with VWD

Presenting Faculty


Robert Sidonio Jr, MD
Robert Sidonio Jr, MD
Associate Director of Hemostasis and Thrombosis
Comprehensive Bleeding Disorder Center
Emory University and Children’s Healthcare of Atlanta
Atlanta, GA


Kenneth D. Friedman, MD
Kenneth D. Friedman, MD
Medical Director, Hemostasis Reference Laboratory, BloodCenter of Wisconsin
Professor of Internal Medicine, Medical College of Wisconsin
Milwaukee, WI

Michelle L. Witkop, DNP, FNP-BC
Michelle L. Witkop, DNP, FNP-BC
Head of Research, National Hemophilia Foundation
New York, NY
Bleeding Disorders Nurse Practitioner
Northern Regional Bleeding Disorders Center
Munson Medical Center
Traverse City, MI

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Educational Concepts in Medicine. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education
The Postgraduate Institute for Medicine designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Pharmacy Education
Postgraduate Institute for Medicine designates this continuing education activity for 0.75 contact hour(s) (.75 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number - JA4008162-9999-18-008-H01-P)
Type of Activity: Application

Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.7 contact hours. Designated for 0.1 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses

During the period of March 29, 2018, through March 29, 2019, participants must:

  • Read the learning objectives and faculty disclosures
  • Study the educational activity
  • Complete the posttest by recording the best answer to each question
  • Complete the evaluation form

A statement of credit will be issued automatically upon successful completion of the post-activity survey with a score of 75% or better and submitting the activity evaluation.

For Pharmacists: Upon successfully completing the post-test with a score of 75% or better and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Fee Information
There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy.  PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Faculty or Presenter Reported Financial Relationship
Robert Sidonio Jr, MD (Chair) Consulting Fees: Aptevo Therapeutics, Bayer, Bioverativ, CSL Behring, Grifols, Novo Nordisk, Octapharma, Pfizer Shire.
Contracted Research: Bioverativ, Grifols, Shire.
Kenneth D. Friedman, MD (Faculty) Salary: BloodCenter of Wisconsin. Consulting Fees: Bayer, CSL Behring.
Fees for Non-CME/CE Services Received Directly from a Commercial Interest or their Agents: Alexion.
Michelle L. Witkop, DNP, FNP-BC (Faculty) Consulting Fees: Aptevo Therapeutics, Baxalta, Bayer, Bioverativ, CSL Behring, Medscape, Novo Nordisk, Pfizer.

Contracted Research: Bioverativ.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Planner or Manager Reported Financial Relationship
PIM Clinical Reviewers: Trace Hutchison, PharmD; Samantha Mattiucci, PharmD, CHCP; Judi Smelker-Mitchek, MBA, MSN, RN; Jan Schultz, RN, MSN, CHCP Have no real or apparent conflicts of interest to report.
Educational Concepts in Medicine: Patrick J. Crowley, MBA, Partner/CEO; Jodi Andrews, BS, Partner/COO; Christine H. Blood, PhD, Medical Writer Have no real or apparent conflicts of interest to report.


Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. 

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. .

This educational activity is supported by an independent medical educational grant from Shire.

This activity is jointly provided by: