This work was supported by an unrestricted grant from the Olitsky Family Foundation.
Article first published online: 6 DEC 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 3, pages 495–497, March 2012
How to Cite
Karnezis, T. T. and Davidson, T. M. (2012), Treatment of hereditary hemorrhagic telangiectasia with submucosal and topical bevacizumab therapy. The Laryngoscope, 122: 495–497. doi: 10.1002/lary.22501
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 21 FEB 2012
- Article first published online: 6 DEC 2011
- Manuscript Accepted: 21 NOV 2011
- Manuscript Revised: 15 NOV 2011
- Manuscript Received: 15 SEP 2011
- Hereditary hemorrhagic telangiectasia;
- vascular endothelial growth factors;
- Level of Evidence: 4
Bevacizumab delivered as a submucosal and topical intranasal therapy effectively controls hereditary hemorrhagic telangiectasia (HHT)-associated epistaxis.
Prospective institutional review board-approved study.
Between December 2009 and December 2010, 19 patients with HHT-associated epistaxis were treated with 100 mg of intranasal submucosal bevacizumab. Following treatment, patients were contacted monthly to report their epistaxis severity score (ESS) for 9 or more months after their initial treatment. If a patient had a significant increase in their ESS, they were offered treatment with 100 mg of topical bevacizumab, administered via a metered dose atomizer. All treatments were recorded.
All 19 patients had a postinjection ESS documented through 9 months, whereas 17 patients had completed ESS data between months 10 and 12. Six of the 19 patients received eight additional 100 mg of topical bevacizumab treatments because they had an increase in their ESS. Results demonstrated a mean preinjection ESS of 8.12, with an ESS nadir of 2.00 reached at 2 months following submucosal injection (P < 0.0001). Over the following 12 months, the mean ESS steadily increased back to a maximum of 3.6 reached at 11 months following injection (P < .0001).
Intranasal submucosal bevacizumab effectively treats HHT-associated epistaxis for up to 12 months following treatment.