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Bevacizumab Reduces Nose Bleeds in Inherited Condition

Researchers report positive results with either injected or nasal spray administration of drug

MONDAY, Feb. 18 (HealthDay News) -- The vascular endothelial growth factor inhibitor bevacizumab administered by intranasal injection, or even by topical nasal spray, can effectively treat epistaxis from hereditary hemorrhagic telangiectasia (HHT), according to reports published in The Laryngoscope.

Jana Simonds, of the University of California in San Diego, and colleagues injected bevacizumab submucosally in the nasal cavities of 10 HHT patients using a spinal needle after initially performing potassium titanyl phosphate (KTP) laser cautery. The results were compared to nine patients treated only with KTP. Eighty percent of the KTP/bevacizumab group reported benefits compared to 56 percent in the KTP-only group, including reduced epistaxis frequency, fewer blood transfusions, and reduced disability and effects on social life.

In a case report, Terence M. Davidson, M.D., also of the University of California in San Diego, and colleagues administered bevacizumab via intranasal topical spray for HHT epistaxis in a 45-year-old male who had nose bleeds almost daily. The bevacizumab was administered twice daily for two weeks (1 mg in a saline solution) and reduced epistaxis to less than once weekly for between three and four months after which epistaxis resumed. The bevacizumab dose was increased to 25 mg (administered in 0.1 mL doses at half-hour intervals). Epistaxis again was reduced and has remained minimal for 2.5 months, the researchers found.

"The clinical and photographic results indicate that this may represent an exciting new option for these patients, which could possibly decrease the morbidity of current laser and surgical treatments," Davidson and colleagues write.

Abstract - Simonds
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Abstract - Davidson
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