Systemic Bevacizumab for Severe Bleeding From Acquired Gastrointestinal Vascular Malformations

Area of Science:

• Gastroenterology
• Vascular Biology
• Oncology

Background:

• Acquired gastrointestinal vascular malformations are a common cause of bleeding in older adults.
• Current treatments are temporizing and do not address the root cause of angiogenic dysregulation.
• Bevacizumab, an anti-VEGF-A therapy, shows potential for treating these conditions.

Purpose of the Study:

• To evaluate the safety and efficacy of bevacizumab in patients with acquired gastrointestinal vascular malformations.
• To assess the impact of bevacizumab on hematologic support needs and clinical outcomes.

Main Methods:

• Observational cohort study of 32 patients with acquired gastrointestinal vascular malformations.
• Patients were treated with bevacizumab on a predefined institutional pathway.
• Hematologic Support Score, red-cell transfusions, iron infusions, and hospitalization rates were analyzed.

Main Results:

• Significant reduction in Hematologic Support Score (p < 0.001) and transfusion/iron requirements.
• Annualized hospitalization/ED visit rate decreased from 3 to 1 (p = 0.01).
• Median hemoglobin increased by 3.1 g/dL (p < 0.001); common side effects included proteinuria and hypertension.

Conclusions:

• Bevacizumab is a novel, targeted therapy for acquired gastrointestinal vascular malformations.
• The treatment demonstrates safety and efficacy in reducing bleeding and improving hematologic parameters.
• Bevacizumab offers a promising therapeutic approach for this patient population.