{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:26:01Z","timestamp":1777386361227,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Epistaxis is a primary complaint in 90% to 96% of patients with hereditary hemorrhagic telangiectasia (HHT). Numerous surgical and medical treatments aim to decrease the frequency and severity of epistaxis in this patient population. Bevacizumab is a recombinant, humanized monoclonal antibody to vascular endothelial growth factor, an angiogenic factor elevated in HHT. It has been used in several forms to treat epistaxis in HHT but thus far, evidence-based recommendations are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Systematic review with evidence-based recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using Embase, MEDLINE, MEDLINE In-Process\/Epub, and Cochrane databases. English language abstracts were reviewed for relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven manuscripts met inclusion criteria and were analyzed. Submucosal injection, submucosal injection plus laser coagulation, intravenous (IV), and topical formulations of bevacizumab were evaluated for their therapeutic impact on epistaxis in patients with HHT. Three randomized controlled trials failed to show topical bevacizumab to be more effective in controlling epistaxis than saline or other moisturizers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of submucosal and IV bevacizumab shows promise, but further study is necessary to determine the true efficacy in the treatment of epistaxis as only grade C level exists currently. Based on the available literature, the use of topical bevacizumab is not recommended (grade B).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1945892418768588","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T07:36:54Z","timestamp":1528184214000},"page":"258-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Bevacizumab for Epistaxis in Hereditary Hemorrhagic Telangiectasia: An Evidence-based Review"],"prefix":"10.1177","volume":"32","author":[{"given":"Ashleigh A.","family":"Halderman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Texas Southwestern, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew W.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Texas Southwestern, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley F.","family":"Marple","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Texas Southwestern, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Sindwani","sequence":"additional","affiliation":[{"name":"Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas D.","family":"Reh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Poetker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"bibr1-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199510053331407"},{"key":"bibr2-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320320302"},{"key":"bibr3-1945892418768588","doi-asserted-by":"crossref","first-page":"155","DOI":"10.4193\/Rhino09.138","volume":"49","author":"Ingrand I","year":"2011","journal-title":"Rhinology"},{"key":"bibr4-1945892418768588","doi-asserted-by":"crossref","first-page":"164","DOI":"10.4193\/Rhino10.090","volume":"49","author":"Loaec ML","year":"2011","journal-title":"Rhinology"},{"key":"bibr5-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-004-7865-y"},{"key":"bibr6-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1177\/194589240501900112"},{"key":"bibr7-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1038\/ng0696-189"},{"key":"bibr8-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1038\/ng1294-345"},{"key":"bibr9-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(20000306)91:1<66::AID-AJMG12>3.0.CO;2-P"},{"key":"bibr10-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.79.927.18"},{"key":"bibr11-1945892418768588","first-page":"818","volume":"90","author":"Sadick H","year":"2005","journal-title":"Haematologica"},{"key":"bibr12-1945892418768588","first-page":"591","volume":"15","author":"Sadick H","year":"2005","journal-title":"Int J Mol Med"},{"key":"bibr13-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e3282f0ca54"},{"key":"bibr14-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26363"},{"key":"bibr15-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20095"},{"key":"bibr16-1945892418768588","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20818"},{"key":"bibr17-1945892418768588","unstructured":"Oxford Centre for Evidence-based Medicine (CEBM)\u2014Levels of Evidence. http:\/\/www.cebm.net\/oxford-centre-evidence-based-medicine-levels-evidence-march-2009. 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