Course of Treatment of Chronic Bleeding and Anemia with Systemic Bevacizumab Treatment in Hereditary Hemorrhagic Telangiectasia: A Retrospective Cohort

Abstract

Objective: Hereditary hemorrhagic telangiectasia (HHT), is an autosomal dominant disorder that causes abnormal angiogenesis. Interest in targeted therapies has been increasing in recent years, especially for the treatment of severe forms of HHT. One of these treatment options is the vascular endothelial growth factor inhibitor bevacizumab. Purpose of this study is to investigate the effect of systemic bevacizumab use on the treatment of chronic bleeding course and anemia in patients diagnosed with HHT. Material and Methods: The treatment response and adverse events of patients with bevacizumab were evaluated retrospectively. Results: The mean age was 51,5. Mean duration of treatment was 15.4 (4-25 months) months. The first 4 doses of 5 mg/kg intravenous bevacizumab were administered at 2-week intervals in all patients. Bevacizumab maintenance continued at a dose of 5 mg/kg in monthly periods. With bevacizumab treatment, an increase in hemoglobin values, a decrease in epistaxis severity score, parenteral iron and erythrocyte transfusion requirement were achieved. Side effects observed were allergic rash in one patient and arthralgia in one patient. None of the patients required discontinuation of treatment due to side effects. Conclusion: Bevacizumab is a promising treatment option in HHT, which can be mortal if not controlled. However, there remains a need for more comprehensive studies in order to achieve a global consensus on treatment protocols and management of adverse events.