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Background <p>Hereditary hemorrhagic telangiectasia is a rare disease of vascular development, often accompanied by severe epistaxis. Multimodality treatment may improve epistaxis control, but the optimal combination of modalities has not yet been established.</p> Objective <p>To study and compare the effects of adding intranasal bleomycin versus local Avastin<sup>®</sup> therapy to laser treatment for epistaxis in patients with hereditary hemorrhagic telangiectasia.</p> Methods <p>We present a case study of all hereditary hemorrhagic telangiectasia patients who underwent laser therapy with or without bleomycin sclerotherapy or local Avastin<sup>®</sup> therapy for epistaxis during 8 consecutive years. We calculated the mean modified posttreatment epistaxis severity score changes, proportions of procedures after which a minimal important difference in modified epistaxis severity score was reached, and intervals between subsequent treatments.</p> Results <p>A higher mean modified epistaxis severity score change was seen after laser treatment combined with bleomycin, compared to laser treatment alone. There was a longer mean treatment interval after both laser combined with Avastin<sup>®</sup>, and laser combined with bleomycin, compared to laser treatment alone.</p> Conclusions <p>Adding bleomycin to laser treatment shows a higher modified epistaxis severity score improvement compared to laser treatment only or laser combined with Avastin<sup>®</sup> in patients with hereditary hemorrhagic telangiectasia. Adding bleomycin or Avastin<sup>®</sup> to laser may lengthen treatment intervals compared to laser therapy alone.</p>

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Intranasal bleomycin sclerotherapy versus local Avastin® therapy as an adjunct to laser treatment for epistaxis in hereditary hemorrhagic telangiectasia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月2日

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  • Karin P. Q. Oomen,
  • Volkert B. Wreesmann,
  • Benjamin J. Waner,
  • Stefan Waner,
  • Milton Waner,
  • Teresa M. O

摘要

Background

Hereditary hemorrhagic telangiectasia is a rare disease of vascular development, often accompanied by severe epistaxis. Multimodality treatment may improve epistaxis control, but the optimal combination of modalities has not yet been established.

Objective

To study and compare the effects of adding intranasal bleomycin versus local Avastin® therapy to laser treatment for epistaxis in patients with hereditary hemorrhagic telangiectasia.

Methods

We present a case study of all hereditary hemorrhagic telangiectasia patients who underwent laser therapy with or without bleomycin sclerotherapy or local Avastin® therapy for epistaxis during 8 consecutive years. We calculated the mean modified posttreatment epistaxis severity score changes, proportions of procedures after which a minimal important difference in modified epistaxis severity score was reached, and intervals between subsequent treatments.

Results

A higher mean modified epistaxis severity score change was seen after laser treatment combined with bleomycin, compared to laser treatment alone. There was a longer mean treatment interval after both laser combined with Avastin®, and laser combined with bleomycin, compared to laser treatment alone.

Conclusions

Adding bleomycin to laser treatment shows a higher modified epistaxis severity score improvement compared to laser treatment only or laser combined with Avastin® in patients with hereditary hemorrhagic telangiectasia. Adding bleomycin or Avastin® to laser may lengthen treatment intervals compared to laser therapy alone.