Bevacizumab nasal spray: Noninvasive treatment of epistaxis in patients with rendu‐osler disease

Abstract

Objectives/Hypothesis: 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. Study Design: 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.