{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:41:33Z","timestamp":1790649693696,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008408","name":"Cure HHT","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008408","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005193","name":"American Academy of Otolaryngology-Head and Neck Surgery","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005193","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Given its role in the disease pathophysiology, inhibition of vascular endothelial growth factor (VEGF)\u2010mediated angiogenesis has received attention as a potential strategy to reduce epistaxis associated with hereditary hemorrhagic telangiectasia (HHT). In this study we evaluated the efficacy of a submucosal injection of bevacizumab, a VEGF inhibitor, in reducing the severity of epistaxis and improving quality of life when given at the time of operative electrocautery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, double\u2010blinded, placebo\u2010controlled trial was conducted at a single institution from 2014 to 2019. Patients scheduled to undergo operative bipolar electrocautery of nasal telangiectasias were randomized to receive a submucosal injection of saline or bevacizumab at time of surgery. Surveys to assess epistaxis severity and quality of life (QOL), including the Epistaxis Severity Score (ESS) and the 12\u2010item Short Form (SF\u201012), were administered preoperatively and at 1, 2, 4, and 6 months postoperatively. The minimal clinically important difference (MCID) of the ESS instrument is reported to be 0.71.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 39 patients enrolled, 37 (94.9%) completed the study. The saline group demonstrated a reduced ESS vs baseline at 1 (\u22121.2; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) and 4 (\u22121.2; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05) months postprocedure. The bevacizumab group demonstrated a reduced ESS score vs baseline at 1 (\u22122.3; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), 2 (\u22122.3; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), 4 (\u22122.0; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), and 6 (\u22121.3; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05) months postprocedure. The additive benefit of bevacizumab over saline exceeded the MCID at 1, 2, and 4 months, but the difference was not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The addition of a single treatment of submucosal bevacizumab may be associated with additional clinically meaningful benefit for up to 4 months when compared with electrocautery alone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22961","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T09:11:05Z","timestamp":1641460265000},"page":"1034-1042","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Randomized, controlled, double\u2010blinded clinical trial of effect of bevacizumab injection in management of epistaxis in hereditary hemorrhagic telangiectasia patients undergoing surgical cauterization"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9960-7758","authenticated-orcid":false,"given":"Ashoke R.","family":"Khanwalkar","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakanksha","family":"Rathor","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia K.","family":"Read","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Paknezhad","sequence":"additional","affiliation":[{"name":"Geisinger Wyoming Valley 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