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Epistaxis is a frequent and debilitating feature of hereditary hemorrhagic telangiectasia (HHT). Nasal packing, laser ablation, and septodermoplasty are often required to control persistent bleeding, and severe iron-deficiency anemia secondary to chronic blood loss is common.
To determine whether topical application of agents with various mechanisms of action decreases epistaxis frequency, investigators conducted a multicenter, double-blind, placebo-controlled, randomized phase II trial of bevacizumab, estriol, tranexamic acid, or saline placebo spray (twice daily for 12 weeks) in 121 HHT patients having weekly episodes of epistaxis lasting at least 1 minute.
Median epistaxis frequency during weeks 5 through 12 (the primary outcome) and the d…