Can the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin) treat hereditary hemorrhagic telangiectasia (HHT) epistaxis?
Background: HHT is an autosomal dominant disorder involving abnormal blood vessel development. An estimated 90 percent of HHT patients have epistaxis which can lead to significant blood loss requiring IV iron, emergency room visits and blood transfusions. Surgical outcomes are generally poor. VEGF has recently been found to be elevated in HHT patients. Bevacizumab (Avastin) is a recombinant, humanized, monoclonal antibody that binds to and inhibits the activity of VEGF.
Explore this issue:February 2010
Study design: Case report of a 45-year-old male with HHT and frequent epistaxis.
Setting: The patient’s epistaxis began prior to 10 years of age. With frequent nosebleeds, anemia and varying hemoglobin levels, he sought treatment at the University of California, San Diego nasal dysfunction clinic.