Overview
WILL MANAGE is a prospective multicenter controlled open label randomized trial comparing an algorithm-based multidisciplinary management to a standard of care to reduce the incidence of bleeding (GI bleeding or severe epistaxis) recurrence in von Willebrand disease.
Eligibility
Inclusion Criteria:
- Males and females adults aged \> 18 years
- With a constitutional von Willebrand Disease (according to the phenotypic criteria of the French Reference Center of von Willebrand Disease)
- With a GI bleeding \[either overt (any hematemesis, any melena or hematochezia with at least a 2g/dL drop in hemoglobin) or occult (iron deficiency anemia with at least 2g/dL drop in hemoglobin)\] with the presence of angiodysplasia or a negative finding on digestive conventional endoscopy OR with a severe epistaxis (requiring red blood cells transfusion or treatment with VWF concentrates)
- Be affiliated to a social security scheme
- Written informed consent obtained
Exclusion Criteria:
- Acquired von Willebrand Disease
- Presence of an inhibitor to VWF or a contra indication to VWF concentrates
- Contra-indication to videocapsule endoscopy
- Refusal of the procedures part of the study
- Pregnant women or breastfeeding
- Short-life expectancy
- Liver cirrhosis Child-Pugh C or diagnosed portal hypertension
- Cancer currently undergoing chemotherapy
- Inability to provide informed consent
- Patient under justice protection
