{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T23:36:28Z","timestamp":1790552188028,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:00:00Z","timestamp":1539043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hereditary haemorrhagic telangiectasia (<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>) is a rare hereditary multisystem vascular disorder causing visceral arteriovenous malformations and mucocutaneous bleeding. Chronic gastrointestinal bleeding and epistaxis often produce profound anaemia refractory to conventional treatment. Bevacizumab, an anti\u2010vascular endothelial growth factor monoclonal antibody, may be effective in treatment of bleeding in<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>patients treated with systemic bevacizumab for chronic bleeding were selected for retrospective analysis. Data collected included demographics, baseline<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>characteristics, epistaxis grade, surgical interventions, bevacizumab dosing, adverse events, haemoglobin, red cell transfusions, intravenous iron infusions, and other anaemia and\/or bleeding\u2010directed therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>patients were treated with bevacizumab for a median of 13.9 (range 4.9\u201330.1) months. Compared with pretreatment values, bevacizumab treatment increased the mean haemoglobin by 4.0 g dL<jats:sup>\u22121<\/jats:sup>(95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2.6\u20135.3 g dL<jats:sup>\u22121<\/jats:sup>) [mean (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) haemoglobin 8.5 (7.8, 9.9) g dL<jats:sup>\u22121<\/jats:sup>vs. 12.5 (11.2, 13.7) g dL<jats:sup>\u22121<\/jats:sup>,<jats:italic>P<\/jats:italic>&lt; 0.001)], reduced red cell units transfused by 92% [median of 6 (range 0\u201359) units vs. 0 (range 0\u201315) units,<jats:italic>P<\/jats:italic>= 0.004] and reduced quantity of iron infused by 73% [mean (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 462 (257, 668) mg month<jats:sup>\u22121<\/jats:sup>vs. 126 (75, 178) mg month<jats:sup>\u22121<\/jats:sup>,<jats:italic>P<\/jats:italic>= 0.002]. Epistaxis control was achieved in 85% with bevacizumab versus 0% before treatment (<jats:italic>P<\/jats:italic>&lt; 0.001). No patient required nasal or<jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content>procedures during the maintenance period. Two patients (15%) developed grade 3 hypertension requiring medical management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Systemic bevacizumab was highly effective to treat chronic bleeding in<jats:styled-content style=\"fixed-case\">HHT<\/jats:styled-content>. Further study is needed to confirm the magnitude of benefit and further define optimal dosing, treatment duration and long\u2010term safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12832","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T01:49:40Z","timestamp":1536284980000},"page":"223-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Systemic bevacizumab for the treatment of chronic bleeding in hereditary haemorrhagic telangiectasia"],"prefix":"10.1111","volume":"285","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6175-1383","authenticated-orcid":false,"given":"H.","family":"Al\u2010Samkari","sequence":"first","affiliation":[{"name":"Division of Hematology Massachusetts General Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kritharis","sequence":"additional","affiliation":[{"name":"Division of Blood Disorders Rutgers Cancer Institute of New Jersey New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Rodriguez\u2010Lopez","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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