Efficacy and safety of propranolol for epistaxis in hereditary haemorrhagic telangiectasia: retrospective, then prospective study, in a total of 21 patients

Contis, A.; Gensous, Noémie; Viallard, J.-F.; Goizet, Cyril; Léauté‐Labrèze, Christine; Duffau, Pierre

doi:10.1111/coa.12821

Cited by 20 publications

(30 citation statements)

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“…In the prospective arm, 11 patients were treated with propranolol for 3 months. Median cumulative duration of epistaxis per month decreased significantly ( p < 0.0001) . In addition, median number of episodes per month ( p < 0.0001) and number of days without epistaxis per month ( p = 0.01) decreased significantly .…”

Section: Resultsmentioning

confidence: 93%

“…Median cumulative duration of epistaxis per month decreased significantly ( p < 0.0001) . In addition, median number of episodes per month ( p < 0.0001) and number of days without epistaxis per month ( p = 0.01) decreased significantly . Regarding side effects, only 1 subject had to discontinue propranolol use secondary to hypotension .…”

Section: Resultsmentioning

confidence: 96%

“…In addition, median number of episodes per month ( p < 0.0001) and number of days without epistaxis per month ( p = 0.01) decreased significantly . Regarding side effects, only 1 subject had to discontinue propranolol use secondary to hypotension . Other side effects included asthenia, nightmares, and erectile dysfunction …”

Section: Resultsmentioning

confidence: 98%

“…A retrospective, then prospective case series by Contis et al treated a total of 21 patients on oral propranolol with doses of between 80 and 160 mg/d. In the retrospective arm, 10 patients treated for a median duration of 16.5 months had a significant decrease in ESS from 8.3 (7.98‐9.44) to 4.5 (4.31‐6.61) ( p = 0.003) . Median duration ( p = 0.003) and frequency ( p = 0.0015) also improved significantly .…”

Section: Resultsmentioning

confidence: 99%

“…In the retrospective arm, 10 patients treated for a median duration of 16.5 months had a significant decrease in ESS from 8.3 (7.98‐9.44) to 4.5 (4.31‐6.61) ( p = 0.003) . Median duration ( p = 0.003) and frequency ( p = 0.0015) also improved significantly . In the prospective arm, 11 patients were treated with propranolol for 3 months.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Medical treatment of epistaxis in hereditary hemorrhagic telangiectasia: an evidence‐based review

Halderman

Ryan

Clark

et al. 2018

Int Forum Allergy Rhinol

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Medical treatment of epistaxis in hereditary hemorrhagic telangiectasia: an evidence‐based review

Halderman

Ryan

Clark

et al. 2018

Int Forum Allergy Rhinol

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Injection of bevacizumab and cyanoacrylate glue for hereditary hemorrhagic telangiectasia

Khoueir

Borsik²,

Camous³

et al. 2019

The Laryngoscope

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Objectives/Hypothesis The objective of this study was to report for the first time on the results of submucosal injections of bevacizumab used in conjunction with cyanoacrylate glue sclerotherapy in hereditary hemorrhagic telangiectasia (HHT). Study Design Retrospective analytic chart review. Methods We performed a chart review that included all patients with HHT treated with intranasal bevacizumab and cyanoacrylate glue for refractory epistaxis at Lariboisiere University Hospital from 2013 with a minimum follow‐up of 6 months. We injected 100 mg (25 mg/mL) of bevacizumab diluted in 2 mL of serum at the base of the telangiectasias, and sclerotherapy with an injection of cyanoacrylate glue was used adjunctively. Treatment efficacy was based on changes in Epistaxis Severity Scores (ESS) and the Bergler‐Sadick Scale. Quality of life and patient satisfaction were evaluated using the Cantril Self‐Anchoring Ladder (CL) and Likert scale, respectively. Results Thirty‐one patients were included, with a mean follow‐up of 26.6 months. The average ESS score significantly decreased from 7.82 to 3.89 (P < .05). The Bergler‐Sadick score significantly improved (P < .05) following the treatment, including the frequency (from 2.74 to 1.64) and the quantity (from 2.54 to 1.51) scales. Quality of life was significantly improved (P < .05) using the CL score (from 4.16 to 7.22). The Likert satisfaction scale related to the treatment efficacy was high, with an average of 7.03 out of 10. No complications were noted. Conclusions Submucosal injections of bevacizumab in conjunction with cyanoacrylate glue sclerotherapy significantly reduced epistaxis and improved the quality of life in HHT. Prospective comparative studies are needed to further evaluate the significance of this treatment modality. Level of Evidence 3b Laryngoscope, 129:2210–2215, 2019

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Sclerotherapy and Topical Nasal Propranolol: An Effective and Safe Therapy for HHT‐Epistaxis

et al. 2019

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Objectives Epistaxis is the most frequent clinical manifestation of hereditary hemorrhagic telangiectasia (HHT). Several topical, systemic, and surgical treatments have been tried, but none have been completely effective. The aim of the present study is to evaluate whether a combined treatment sclerotherapy and topical therapy with propranolol 0.5% nasal formulation would reduce the epistaxis due to HHT and improve patient's quality of life. Methods An observational cross‐sectional study was carried out. The primary outcome measure was frequency and severity of epistaxis as measured by the epistaxis severity score (ESS) at baseline (4 weeks before therapy) and at least 4 weeks after the treatment was implemented. Quality of life was analyzed using EuroQol‐5D (EQ‐5D) scale and visual analogue (VAS) scale before and after treatment. Results A total of 38 consecutive patients subjected to the combined treatment were evaluated (mean age: 57.2 years, standard deviation [SD] = 13.9; 60.5% women). The mean time of treatment was 37.1 weeks (SD = 14.9). Combined therapy significantly reduces frequency and severity of epistaxis, with an ESS improvement of 5 points from 6.9 ± 2.6 to 1.9 ± 1.3 (P < 0.05); however, the EQ‐5D scale increased from 0.66 ± 0.27 to 0.93 ± 0.12 (P < 0.05). The difference in VAS means showed an increase from 44.6 ± 28.3 to 82.5 ± 12.5 (P < 0.05). The increases in quality of life are in line with the drop in ESS. Conclusion The study demonstrated that combined therapy (sclerotherapy and topical nasal propranolol) significantly reduced the epistaxis due to HHT and increased patients’ quality of life. Level of Evidence 2c Laryngoscope, 129:2216–2223, 2019

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Efficacy and safety of propranolol for epistaxis in hereditary haemorrhagic telangiectasia: retrospective, then prospective study, in a total of 21 patients

Cited by 20 publications

References 10 publications

Medical treatment of epistaxis in hereditary hemorrhagic telangiectasia: an evidence‐based review

Medical treatment of epistaxis in hereditary hemorrhagic telangiectasia: an evidence‐based review

Injection of bevacizumab and cyanoacrylate glue for hereditary hemorrhagic telangiectasia

Sclerotherapy and Topical Nasal Propranolol: An Effective and Safe Therapy for HHT‐Epistaxis

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