Hereditary Hemorrhagic Telangiectasia (HHT) Clinical Trial
Official title:
Ranibizumab for the Management of Recurrent Epistaxis in Patients With Hereditary Hemorrhagic Telangiectasia (HHT)
This study is for patients with recurrent epistaxis (nosebleeds) as a result of Hereditary Hemorrhagic Telangiectasia (HHT). The aim is to determine if ranibizumab, topically applied will diminish epistaxis in patients with HHT as measured by the HHT Epistaxis Severity Score (ESS), hematocrit, and hemoglobin and serum ferritin levels.
This is an open-label, Phase I study of intranasal administered ranibizumab in subjects with
HHT. Plans are to recruit patients with HHT from the UCSD Nasal Dysfunction Clinic.
Those who come for evaluation and are deemed appropriate for topical ranibizumab without
laser will be recruited for this study. Ten (10) consented, enrolled subjects will receive a
pulsatile nasal irrigator to clean their nose twice daily. They will complete the initial
ESS and have a blood test for Hct, Hgb, serum ferritin, liver function tests, renal function
tests and if of child-bearing age, a urine pregnancy test. They will return 1 week later and
will then receive intranasal sprays of ranibizumab administered once per week during clinic.
Patients will be treated with a total of 4 applications of ranibizumab in a fine mist spray.
This will be done with 2 mgs in 0.2cc; 0.1cc sprayed into each nostril a day; therefore 8
mgs will require 4 days of application. If, following the first treatments, they experience
recurrent bleeding (equal to or less than a 75% reduction in their ESS number as compared to
pre treatment), they will be offered the opportunity to be prescribed a second
administration, to be completed in the same way (4 applications of 4 mg in 0.4 cc with 0.2cc
per nostril).
At the completion of the treatment, subjects will be observed monthly for examination and
ESS until 6 months from the first treatment. At 3 and 6 months laboratory tests will be
performed.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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