Back to Search
Start Over
Intravenous Bevacizumab in Hereditary Hemorrhagic Telangiectasia-Related Bleeding and High-Output Cardiac Failure: Significant Inter-Individual Variability in the Need for Maintenance Therapy.
- Source :
-
Mayo Clinic proceedings [Mayo Clin Proc] 2020 Aug; Vol. 95 (8), pp. 1604-1612. - Publication Year :
- 2020
-
Abstract
- Objective: To present our center's experience with a maintenance treatment algorithm for intravenous bevacizumab that allows for personalized therapy decisions.<br />Patients and Methods: We reviewed all patients treated with intravenous bevacizumab for hereditary hemorrhagic telangiectasia-related bleeding and/or high-output cardiac failure (HOCF) from January 1, 2013, to July 1, 2019, at the Mayo Clinic, Rochester, Minnesota. Data regarding subsequent bevacizumab dosing were abstracted.<br />Results: A total of 57 patients (n=40, 70.2% females) were identified with a median age of 65 (55 to 74; range, 37 to 89) years. High-cardiac output state was present in 21 patients (36.8%) and 10 (17.5%) were treated with intravenous bevacizumab primarily for HOCF. The median duration of follow-up after completion of the initial intravenous bevacizumab treatment was 25 (12.3 to 40.8; range, 0.1 to 65.4) months. A total of 20 (35.1%) patients with a median follow-up of 13.5 (range, 0 to 48.4) months required no maintenance dosing throughout the duration of follow-up. Among those who required subsequent maintenance doses, only a small fraction (8 patients; 14.0%) required regular maintenance doses every 4 to 8 weeks during follow-up whereas the majority of patients required intermittent "as-needed" doses at varying intervals.<br />Conclusion: There is significant inter-individual variability in the need for maintenance intravenous bevacizumab when patients are followed using a predefined bevacizumab maintenance dosing treatment algorithm. The use of "as-needed" maintenance bevacizumab appears to be an effective strategy for management of hereditary hemorrhagic telangiectasia-related bleeding and HOCF.<br /> (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Angiogenesis Inhibitors administration & dosage
Bevacizumab administration & dosage
Female
Heart Failure etiology
Hemorrhage etiology
Humans
Individuality
Injections, Intravenous
Male
Middle Aged
Precision Medicine methods
Retrospective Studies
Telangiectasia, Hereditary Hemorrhagic complications
Angiogenesis Inhibitors therapeutic use
Bevacizumab therapeutic use
Heart Failure drug therapy
Hemorrhage drug therapy
Telangiectasia, Hereditary Hemorrhagic drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1942-5546
- Volume :
- 95
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Mayo Clinic proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 32753135
- Full Text :
- https://doi.org/10.1016/j.mayocp.2020.03.001