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Evaluating the Role of Bevacizumab in Reducing Epistaxis in Patients with Hereditary Hemorrhagic Telangiectasia: A Systematic Review and Meta-Analysis

Clinical Genetics and Therapeutics
  • Primary Categories:
    • Clinical- Pediatric
  • Secondary Categories:
    • Clinical- Pediatric
Introduction:
Hereditary Hemorrhagic Telangiectasia (HHT) is a genetic disorder characterized by telangiectasias and arteriovenous malformations, often leading to recurrent epistaxis that significantly impacts patients’ quality of life. Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF), has emerged as a potential therapy to reduce the severity and frequency of these bleeding episodes. This systematic review and meta-analysis aim to evaluate the evidence supporting Bevacizumab’s role in managing epistaxis in HHT.

Methods:
A systematic search of PubMed, Cochrane, and Embase databases was conducted to identify randomized controlled trials and observational studies assessing the effects of Bevacizumab on epistaxis in HHT patients. Inclusion criteria focused on studies reporting epistaxis severity, frequency, duration, or quality-of-life outcomes. All statistical analyses were performed in R software version 4.3.2, using the ‘meta’ and ‘metafor’ packages.

Results:
A total of 8 studies were included in the analysis. Treatment with Bevacizumab demonstrated a significant reduction in epistaxis severity scores, with a pooled Mean Difference (MD) of 2.29 (95% CI: 1.16 to 3.43) in the random-effects model, indicating consistent improvements across most studies. Regarding hemoglobin levels, the common-effect model estimated a mean increase of 1.75 g/dL (95% CI: 1.74 to 1.77), suggesting a reliable overall benefit. These findings support the potential of Bevacizumab to reduce epistaxis severity and improve hemoglobin levels, although the variability across studies highlights the need for further research to confirm these effects.

Conclusion:
Bevacizumab appears to be an effective treatment for reducing epistaxis severity in patients with HTT , as evidenced by a significant improvement in severity scores. Additionally, the treatment showed a positive impact on hemoglobin levels. The findings suggest that Bevacizumab may improve the quality of life for patients with HHT; however, further high-quality studies are necessary to validate its efficacy and address the observed heterogeneity in outcomes.

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