title: Intravenous and topical intranasal bevacizumab (Avastin) in hereditary hemorrhagic telangiectasia.
abstract: Current treatment of severe epistaxis in patients with hereditary hemorrhagic telangiectasia is not durable in reducing the frequency and severity of bleeds. Recent reports have demonstrated marked improvement of epistaxis with administration of either intravenous or topical bevacizumab. We present the long-term outcome of a patient who received repeated treatments of intravenous bevacizumab followed by maintenance intranasal bevacizumab. We demonstrate durable control of epistaxis with intranasal bevacizumab. This allows delivery of bevacizumab effectively, reduces cost, and obviates the risk of systemic adverse effects related to bevacizumab.
authors.affiliation: Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Brinkerhoff
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Choong
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Treisman
authors.forename: David M
authors.initials: DM
authors.lastname: Poetker
mesh_terms: D000281:Administration, Intranasal; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010976:Platelet Count; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab