Beta Blocker Fails to Stop Hereditary Hemorrhagic Telangiectasia-Associated Nosebleeds

According to a recent study published in Nature Research, a team of scientists studied the efficacy of timolol in treating nosebleeds associated with hereditary hemorrhagic telangiectasia. Timolol is a beta blocker, used to reduce blood pressure — especially intraocular blood pressure.

About Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) is a genetically inherited disorder characterized by numerous abnormalities of the blood vessels. In some places, arteries may connect directly to veins rather than capillaries. Veins are less robust than arteries, and without the protective effects of the capillaries to mediate blood pressure, they wear down under continuous exposure to the higher pressure blood carried by arteries.

Because of the higher blood pressure in their veins, nosebleeds are frequent in HHT patients. In more serious cases, blood vessel abnormalities can cause severe bleeding episodes in vital organs, including the liver, lungs, and brain. Cases of HTT are differentiated from one another by their age of onset and the principle area of the body affected.

The condition is caused by a genetic mutation to any of several known genes, including ACVRL1ENG, and SMAD4. These genes play important roles in the development of proteins that are involved of the formation of young blood vessels — particularly arteries. Mutations to different genes result in different types of the disease.

Nasal Spray Tested As Viable Preventative for Nosebleeds

The study authors hypothesized that 50% of patients receiving timolol in the form of a nasal spray would experience improvement in the overall time spent with nosebleeds over the course of a month (compared to the 15% they predicted would improve in the control group).

58 participants were involved in the study, divided equally into control and active groups of 29 people each. At the end of the study, researchers found no significant improvement in the duration of nosebleeds in the active group compared to placebo; the hypothesis had failed.

Researchers wondered if the relatively short period time of experimentation influenced the results. Briefly, the team considered if a month simply wasn’t enough time for timolol to take effect. However, the patients who did respond to the spray (just 27.6% of the active group) improved in just a few days. It is unlikely, then, that additional time would be necessary for timolol to be effective.

It simply seems unlikely that the beta blocker will be effective in treating HHT-associated nosebleeds.

What do you think of this study’s findings? Do you or does anyone you know have HHT? How do you deal with nosebleeds? Share your thoughts with Patient Worthy!

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