{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:21:23Z","timestamp":1770888083727,"version":"3.50.1"},"reference-count":47,"publisher":"American Society of Hematology","issue":"10","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Persons with mild hemophilia A (HA) may use intranasal desmopressin prior to sports participation. Desmopressin is expensive and can cause vomiting, headache, palpitation, and occasionally seizures. Our group has previously documented a 2.3-fold increase in factor VIII activity (FVIII:C) in adolescents with mild HA after moderate-intensity aerobic exercise. Herein, we report principal findings of a randomized trial of intranasal desmopressin vs a standardized, moderate-intensity aerobic exercise regimen in adolescents with mild HA. Our primary objective was to compare the change in FVIII:C associated with these 2 interventions. We also examined changes in hemostatic parameters arising from their sequential administration. The study was conducted simultaneously at the Hospital for Sick Children, Canada, and Nationwide Children\u2019s Hospital, USA. Thirty-two eligible male adolescents (mean age \u00b1 standard deviation: 16.1 \u00b1 2.6 years) with mild HA (mean baseline FVIII:C: 27.9% \u00b1 18.4%) were randomized to 1 of 4 study arms (desmopressin followed by exercise, desmopressin alone, exercise followed by\u00a0desmopressin, and exercise alone). Blood work was obtained at baseline and at 3\u00a0subsequent time-points. Participants randomized to exercise cycled on an ergometer for approximately 12 minutes, with the final 3 minutes at 85% of their predicted maximum heart rate. Standard weight-based dosing of desmopressin was used. Mean immediate increase in FVIII:C was 1.7-fold with exercise compared with 1.9-fold with desmopressin (noninferiority, P = .04). Exercise-induced improvement in hemostatic parameters including FVIII:C was brief compared with more sustained improvements seen with desmopressin. More than 60% of participants randomized to receive both exercise and desmopressin achieved normal (&amp;gt;50%) FVIII:C, 75 and 135 minutes into the study protocol.<\/jats:p>","DOI":"10.1182\/blood.2022016146","type":"journal-article","created":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T20:16:46Z","timestamp":1657916206000},"page":"1156-1166","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":4,"title":["Moderate-intensity aerobic exercise vs desmopressin in adolescent males with mild hemophilia A: a randomized trial"],"prefix":"10.1182","volume":"140","author":[{"given":"Riten","family":"Kumar","sequence":"first","affiliation":[{"name":"1Dana Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, MA;"},{"name":"2Department of Pediatrics, Harvard Medical School, Boston, MA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9645-6365","authenticated-orcid":false,"given":"Amy L.","family":"Dunn","sequence":"additional","affiliation":[{"name":"3Division of Hematology\/Oncology, Nationwide Children\u2019s Hospital, Columbus, OH;"},{"name":"4Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-9101","authenticated-orcid":false,"given":"Jane E.","family":"Schneiderman","sequence":"additional","affiliation":[{"name":"5Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada;"},{"name":"6Department of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0466-7809","authenticated-orcid":false,"given":"Anne","family":"Gonzales","sequence":"additional","affiliation":[{"name":"7Division of Clinical Therapies, Nationwide Children\u2019s Hospital, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Bouskill","sequence":"additional","affiliation":[{"name":"8Division of Hematology\/Oncology, The Hospital for Sick Children, Toronto, ON, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-2419","authenticated-orcid":false,"given":"Pamela","family":"Widener","sequence":"additional","affiliation":[{"name":"3Division of Hematology\/Oncology, Nationwide Children\u2019s Hospital, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-2102","authenticated-orcid":false,"given":"Joseph","family":"Stanek","sequence":"additional","affiliation":[{"name":"3Division of Hematology\/Oncology, Nationwide Children\u2019s Hospital, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0451-5840","authenticated-orcid":false,"given":"Fred G.","family":"Pluthero","sequence":"additional","affiliation":[{"name":"8Division of Hematology\/Oncology, The Hospital for Sick Children, Toronto, ON, Canada;"},{"name":"9Research Institute, The Hospital for Sick Children, Cell Biology Program, Toronto, ON, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1522-6021","authenticated-orcid":false,"given":"Amanda","family":"Waller","sequence":"additional","affiliation":[{"name":"10Center for Clinical and Translational Research, Abigail Wexner Research Institute, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-9972","authenticated-orcid":false,"given":"Cristina","family":"Tarango","sequence":"additional","affiliation":[{"name":"11Division of Hematology, Cincinnati Children\u2019s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Ahuja","sequence":"additional","affiliation":[{"name":"12Division of Pediatric Hematology\/Oncology, UH Rainbow Babies and Children\u2019s Hospital, Cleveland, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1756-8271","authenticated-orcid":false,"given":"Bryce A.","family":"Kerlin","sequence":"additional","affiliation":[{"name":"3Division of Hematology\/Oncology, Nationwide Children\u2019s Hospital, Columbus, OH;"},{"name":"4Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH;"},{"name":"10Center for Clinical and Translational Research, Abigail Wexner Research Institute, Columbus, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2832-7158","authenticated-orcid":false,"given":"Walter H. A.","family":"Kahr","sequence":"additional","affiliation":[{"name":"8Division of Hematology\/Oncology, The Hospital for Sick Children, Toronto, ON, Canada;"},{"name":"9Research Institute, The Hospital for Sick Children, Cell Biology Program, Toronto, ON, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret L.","family":"Rand","sequence":"additional","affiliation":[{"name":"8Division of Hematology\/Oncology, The Hospital for Sick Children, Toronto, ON, Canada;"},{"name":"13Research Institute, The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lillicrap","sequence":"additional","affiliation":[{"name":"14Department of Pathology and Molecular Medicine, Queens University, Kingston, ON, Canada; 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