Bevacizumab nasal spray: Noninvasive treatment of epistaxis in patients with rendu-osler disease

Authors

  • Romain Guldmann MD,

    Corresponding author
    1. Department of Otorhinolaryngology,Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France
    • Service d'Oto- Rhino-Laryngologie et de chirurgie Cervico-Faciale, Hôpitaux universitaires de Strasbourg, 1, avenue Moliere, 67000 Strasbourg, Alsace, France
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  • Agnes Dupret MD,

    1. Department of Otorhinolaryngology,Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France
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  • Yasmine Nivoix PhD,

    1. Department of Pharmacy, Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France
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  • Philippe Schultz PhD, MD,

    1. Department of Otorhinolaryngology,Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France
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  • Christian Debry PhD, MD

    1. Department of Otorhinolaryngology,Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the efficacy and safety of bevacizumab administered at a concentration of 50 mg as an intranasal spray in the treatment of epistaxis in patients suffering from Rendu-Osler disease.

Study Design:

Prospective.

Methods:

A preliminary, prospective, review board-approved study was conducted on six patients with Rendu-Osler disease who received 10 treatment courses of 50 mg bevacizumab. Monthly follow-up was based on the epistaxis severity score (ESS), with adverse effects being reported.

Results:

Ten treatment courses were administered to six patients, with a mean follow-up period of 2.8 months. A statistically significant decrease in mean ESS was observed at 1 month (P < .001) and 2 months (P < .005), whereas a nonsignificant decrease was found at 3 months (P = .07). A nonsignificant decline in mean ESS was detected at 1 month in patients with ESS ≥7 at baseline. No adverse effects were reported.

Conclusions:

The intranasal spray application of 50 mg bevacizumab was found to be an effective symptomatic treatment over a period of 2 months for patients with a pretreatment ESS of <7, with no adverse effects being noted.

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