Avastin for Hereditary Hemorrhagic Telangiectasia – pro

gement of Hereditary Hemorrhagic Teelangiectasia (HHT) epistaxis, multiple approaches have been tried, but currently there is no established medical treatment available for these patients. Surgical options, such as are being considered for this patient, are largely palliative, with variable and temporary results. The evidene for Avastin in this condition is on the level of cse reports. In the previously reported cases, the dose of bevacizumab varied from 5 mg per kilogram (mg/kg) body weight1,4-10 to 10 mg/kg body weight3 administered every 2 weeks. The elimination half-life of bevacizumab has been determined to be 18 to 20 days; however, in the study done by Dupuis-Girod et al it was found to be 21.5 days. The optimal dose and schedule of administration of bevacizumab in the treatment of HHT is unknown.

 

W Shovlin C, Ganesan V. Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2014. Literature review current through October 2014

Shovlin CL. Hereditary haemorrhagic telangiectasia: pathophysiology, diagnosis and treatment. Blood Rev 2010; 24:203.

  • Narendranath Epperla et al, Blessing for the Bleeder: Bevacizumab in Hereditary Hemorrhagic Telangiectasia . CM&R Rapid Release. Published online ahead of print March 25, 2014 as doi:10.3121/cmr.2013.1205
  • Bose P, Holter JL, Selby GB. Bevacizumab in hereditary hemorrhagic telangiectasia. N Engl J Med 2009;360:2143–2144. 4. Oosting S, Nagengast W, de Vries E. More on bevacizumab in hereditary hemorrhagic telangiectasia. N Engl J Med 2009;361:931; author reply 931–932.
  • Dupuis-Girod S, Ginon I, Saurin JC, Marion D, Guillot E, Decullier E, Roux A, Carette MF, Gilbert-Dussardier B, Hatron PY, Lacombe P, Lorcerie B, Rivière S, Corre R, Giraud S, Bailly S, Paintaud G, Ternant D, Valette PJ, Plauchu H, Faure F. Bevacizumab in patients with hereditary hemorrhagic telangiectasia and severe hepatic vascular malformations and high cardiac output. JAMA 2012;307:948–955.
  • Retornaz F, Rinaldi Y, Duvoux C. More on bevacizumab in hereditary hemorrhagic telangiectasia. N Engl J Med 2009;61: 931; author reply 931–932.

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