Observation on the Efficacy of Bevacizumab in the Treatment of Hereditary Haemorrhagic Telangiectasia
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- ESS
研究概览
简要总结
Clinical Study Abstract (Ethics Application) Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant vascular disorder characterized by recurrent intractable epistaxis and multi-organ arteriovenous malformations. Moderate-to-severe patients often develop refractory anemia with severely impaired quality of life. Current stepwise therapeutic strategies have substantial limitations, including frequent adverse reactions of thalidomide, high recurrence rates after electrocoagulation, and severe surgical trauma, resulting in a lack of safe and individualized treatment options. Our preliminary clinical practice has verified the promising efficacy and long-term benefits of bevacizumab in severe HHT-related epistaxis. However, obvious interindividual variability and occasional adverse events exist, and the underlying mechanism remains unclear. This study aims to systematically evaluate the efficacy and safety of bevacizumab for severe HHT-associated epistaxis, explore the influences of baseline clinical and genetic factors on prognosis, and investigate the mechanism of treatment heterogeneity, so as to optimize individualized therapeutic strategies and provide clinical evidence for precise management of HHT in China.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 75 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Definite HHT diagnosis is established by either clinical assessment according to the Curaçao criteria or genetic confirmation.
- •Clinical diagnosis (Curaçao criteria)
- •Patients who meet at least 3 of the following 4 items are diagnosed with definite HHT:
- •Spontaneous, recurrent epistaxis Multiple mucocutaneous telangiectasias at typical sites Visceral arteriovenous malformations (lung, liver, brain, gastrointestinal tract, etc.) Positive family history of HHT in a first-degree relative Genetic diagnosis Identification of a pathogenic germline mutation in HHT-associated genes (ENG, ACVRL1) confirms the diagnosis of HHT.
排除标准
- •Minors, patients with mild epistaxis that can be well controlled by other treatments, and patients with any contraindication to bevacizumab treatment.
研究组 & 干预措施
Active comparator
Surgery combined with oral thalidomide
干预措施: nasal electrocoagulation. (Procedure)
Active comparator
Surgery combined with oral thalidomide
干预措施: Thalidomide (50mg) (Drug)
Experiment
surgery combined with intravenous injection of bevacizumab
干预措施: nasal electrocoagulation. (Procedure)
Experiment
surgery combined with intravenous injection of bevacizumab
干预措施: Bevacizumab (Drug)
结局指标
主要结局
ESS
时间窗: 1,3.6.12 months after surgery
Epistaxis Severity Score
Hb
时间窗: 1,3,6,12months after surgery
Hemoglobin (Hb)
次要结局
未报告次要终点
