High importance
Jul 30, 2026
To evaluate the effective dose of intranasal bevacizumab for treating epistaxis in patients with Hereditary Hemorrhagic Telangiectasia (HHT).
The study involved local submucosal injections of bevacizumab in the nasal mucosa of HHT patients experiencing recurrent epistaxis, with outcomes measured based on frequency, duration of bleeding episodes, and quality of life improvements.
Treatment with intranasal bevacizumab resulted in a significant reduction in the frequency and duration of epistaxis episodes, leading to decreased blood transfusion requirements and enhanced social functioning for patients.
The study's limitations include a small sample size and the lack of long-term follow-up data to assess the durability of the treatment effects and potential side effects resulting from repeated injections.
This research highlights a promising treatment alternative for managing epistaxis in HHT patients, potentially improving their quality of life. It suggests a novel application of bevacizumab beyond its conventional uses, emphasizing its role in addressing a critical symptom affecting HHT patients.
Epistaxis are present in over 90 % of patients with Rendu - Osler . They involve no significant difference 2 sexes. They often appear in childhood and adolescence and are present in three-quarters of patients at the age of 20 years. These epistaxis increasing in frequency and volume to the age of 60 in 2/3 of patients. Epistaxis are spontaneous , repetitive and recurring . They are highly variable in duration, intensity and frequency of occurrence . Some patients may have more than 40 monthly episodes with mean duration of 5 minutes of bleeding and chronic anemia and can sometimes acute anemia with transfusions need to be source. These epistaxis stigmatize patients and inevitably affect their quality of life and social skills . The various proposed ( cauterization , intra- mucosal injections, laser selective hémostatses , embolization or surgical dermoplasties ) allow for some short-term remissions . Bevacizumab is an antiangiogenic use in the treatment of colorectal cancers . It is also used in ophthalmology intravitreal to reduce vascular proliferation in glaucoma retinopathy and certain corneal neovascularization. In 2009, Prithviraj reported the use of bevacizumab injection to treat pulmonary arteriovenous malformations in a patient with Rendu - Osler . The result is doubly interesting including a saving action on epistaxis which decrease in frequency and duration. This communication prompted the authors to focus more on this medication. The product has been used in local submucosal injection intranasal laser was coupled with satisfactory results objectified by a decrease in the number of epistaxis , reducing blood transfusions and improved social lives. The use of local instillation bevacuzimab represents a way forward for the treatment of these epistaxis.