Treatment of bleeding gastrointestinal vascular malformations with oestrogen-progesterone.
10 patients with frequent and severe bleeding from gastrointestinal vascular malformations took part in a double-blind, placebo-controlled, cross-over trial of a daily dose of 0.05 mg ethinyloestradiol plus 1 mg norethisterone given by mouth. Each arm of the trial lasted 6 months. Oestrogen-progesterone significantly decreased the transfusion need from 10.9 to 1.1 units packed cells (p less than 0.003). While on oestrogen-progesterone 2 of 9 patients required transfusions (mean 1.1 units packed cells per patient over 6 months), whereas all patients had to be transfused while on placebo (mean 10.9 units per patient over 6 months; p = 0.002 for number of patients). No significant excess of side-effects was noted with the active agents. The findings indicate that oestrogen-progesterone is an effective treatment for severely bleeding gastrointestinal vascular malformations.
van Cutsem
E
E
Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Rutgeerts
P
P
Vantrappen
G
G
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D001165:Arteriovenous Malformations / Q000150:complications*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D004064:Digestive System / Q000098:blood supply*; D004311:Double-Blind Method; D004338:Drug Combinations; D004341:Drug Evaluation; D017707:Erythrocyte Transfusion; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D009640:Norethindrone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013997:Time Factors
D004338:Drug Combinations; D004997:Ethinyl Estradiol; D009640:Norethindrone