DDAVP and von Willebrand disease

How does DDAVP work in the treatment of von Willebrand disease?

DDAVP is a synthetic analog of vasopressin, the antidiuretic hormone. Within 1 to 2 hours of its administration (either intravenous, subcutaneous, or intranasal), plasma vWF levels increase by 2-fold to 8-fold. DDAVP appears to act by causing the release of vWF from the endothelial cells. Factor VIII levels also increase in part because of the increased stabilization of vWF/factor VIII complex by DDAVP, which lessens proteolytic degradation. As a caution, DDAVP administration in the setting of von Willebrand disease type IIB may cause a dangerous drop in platelet count due to increased vWF binding and platelet clearance.