title: Bevacizumab nasal spray: Noninvasive treatment of epistaxis in patients with Rendu-Osler disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Otorhinolaryngology, Hôpitaux universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, Alsace, France. romain.guldmann@chru-strasbourg.fr
authors.forename: Romain
authors.initials: R
authors.lastname: Guldmann
authors.forename: Agnes
authors.initials: A
authors.lastname: Dupret
authors.forename: Yasmine
authors.initials: Y
authors.lastname: Nivoix
authors.forename: Philippe
authors.initials: P
authors.lastname: Schultz
authors.forename: Christian
authors.initials: C
authors.lastname: Debry
mesh_terms: D000281:Administration, Intranasal; D000336:Aerosols; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004305:Dose-Response Relationship, Drug; D004844:Epistaxis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059085:Nasal Sprays; D011446:Prospective Studies; D011788:Quality of Life; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A
chemical_list: D000336:Aerosols; D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D059085:Nasal Sprays; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab