title: Antiestrogen therapy for hereditary hemorrhagic telangiectasia: a double-blind placebo-controlled clinical trial.
abstract: OBJECTIVE
  Hereditary hemorrhagic telangiectasia (HHT) is associated with recurrent epistaxis in 90% of cases. Good response to hormone treatment has been documented, although its use remains controversial. The aim of this study was to examine the efficacy of an antiestrogenic agent, Tamoxifen, in the treatment of HHT-associated epistaxis.
  
  
  METHODS
  Twenty-five patients (11 men, 14 women; mean age 51 years) with a diagnosis of epistaxis due to HHT were randomly assigned to receive treatment with oral tamoxifen 20 mg/d or placebo for 6 months. Follow-up consisted of physical examination and once-monthly blood tests.
  
  
  RESULTS
  The groups were similar in age and sex distribution. Of the 21 participants who completed the trial, alleviation of the epistaxis was noted in 9 of 10 tamoxifen-treated patients and 3 of 11 placebo-treated patients (including 2 with only temporary improvement). The difference between the groups at the trial end point was significant for both frequency (P = .01) and severity (P = .049) of the disease. Hemoglobin concentration rose in 4 tamoxifen-treated patients and decreased in 5 controls.
  
  
  CONCLUSIONS
  Tamoxifen appears to be an effective agent for the treatment of epistaxis due to HHT.
authors.affiliation: Nose and Sinus Institute, Rabin Medical Center, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. docyaniv@yahoo.com
authors.forename: Eitan
authors.initials: E
authors.lastname: Yaniv
authors.forename: Michal
authors.initials: M
authors.lastname: Preis
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.forename: Jacob
authors.initials: J
authors.lastname: Shvero
authors.forename: Miriam
authors.initials: M
authors.lastname: Haddad
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004844:Epistaxis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012720:Severity of Illness Index; D013629:Tamoxifen / Q000627:therapeutic use*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D013629:Tamoxifen