Intranasal submucosal bevacizumab for epistaxis in hereditary hemorrhagic telangiectasia: a double-blind, randomized, placebo-controlled trial

Head Neck. 2015 Jun;37(6):783-7. doi: 10.1002/hed.23655. Epub 2014 Apr 30.

Abstract

Background: The purpose of this study was to investigate the efficacy of bevacizumab ("Avastin") for the treatment of epistaxis in hereditary hemorrhagic telangiectasia (HHT).

Methods: In this double blind, placebo controlled trial, 15 adult patients with HHT with a minimum of 2 epistaxis episodes per week were randomized. A history of thromboembolic events or recent or planned surgery led to exclusion. Patients received a single intranasal submucosal injection (10 mL) of 100 mg bevacizumab or placebo. The primary outcome was the relative reduction of average daily epistaxis visual analog score (VAS).

Results: Average daily posttreatment VAS scores decreased by 27% in the bevacizumab group and by 3% in the placebo group (p = .57). The reduction in HHT epistaxis severity scores was -0.61 greater in the bevacizumab group compared to the placebo group (p = .34).

Conclusion: Results show a trend toward reduced epistaxis with bevacizumab. This further supports the use of bevacizumab in HHT. Clincial Trials. gov number: NCT01314274

Keywords: Rendu-Osler-Weber syndrome; avastin; hereditary hemorrhagic telangiectasia (HHT).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intranasal
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Austria
  • Bevacizumab / administration & dosage*
  • Double-Blind Method
  • Epistaxis / drug therapy*
  • Epistaxis / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Nasal Mucosa / drug effects*
  • Pain Measurement
  • Risk Assessment
  • Severity of Illness Index
  • Telangiectasia, Hereditary Hemorrhagic / complications*
  • Telangiectasia, Hereditary Hemorrhagic / diagnosis
  • Treatment Outcome
  • Young Adult

Substances

  • Bevacizumab

Associated data

  • ClinicalTrials.gov/NCT01314274