Pieces of the von Willebrand disease treatment puzzle. The current available options for the treatment of VWD have remained essentially unchanged for years. While the use of plasma-derived VWF (pdVWF:FVIII) was a major advance over plasma or cryoprecipitate, it is still associated with allergic reactions and the potential to transmit infectious agents. Desmopressin (DDAVP) remains an effective treatment for mild bleeds or procedures, and has the advantage of home treatment. Its use is limited to just a few doses. Inhibitors of fibrinolysis are useful for bleeds in mucosal tissue, but play a limited role. It is anticipated that rVWF will offer a more complete treatment paradigm to patients with VWD.