, Volume 68, Issue 12, pp 1685-1686
Date: 30 May 2012

Bevacizumab treatment in hereditary hemorrhagic teleangiectasia

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To the Editor,

Taugourdeau-Raymond and co-workers reported a high frequency of severe bevacizumab-induced adverse effects in the January 2012 issue of this journal [1]. Although only patients with malignant disorders were included, these data are of outstanding importance. Nowadays bevacizumab is increasingly used for off-label treatment, e.g., in macular degeneration and hereditary hemorrhagic teleangiectasia (HHT) (Morbus Osler-Rendu-Weber syndrome). Assessment of the risk-benefit ratio demands awareness of treatment failures in this setting.

There are several reports on positive effects of treating HHT with bevacizumab, an antibody against the vascular endothelial growth factor (VEGF) [29]. This is the first report on failure of this therapy. HHT is characterized by arteriovenous malformations that may occur in various organs and lead to epistaxis and gastrointestinal and pulmonary bleeding among other manifestations. There is no curative therapy so far.

We report on two patients with ...