Recurrent Epistaxis in HHT: What Treatment Is Recommended?

Recurrent nosebleeds are the most prevalent and often most debilitating problem in patients with hereditary hemorrhagic telangiectasia. A structured treatment approach is needed when episodes are frequent or severe.

Clinical scenario

Recurrent epistaxis in a patient with confirmed HHT. Recurrent and often severe epistaxis is the most common manifestation of HHT, occurring in more than 90% of adults with the condition.

Treatment approach — partial overview

Evidence-based options include an oral antifibrinolytic agent or local ablative procedures targeting the nasal mucosa; complete dosing, escalation criteria, and selection guidance are in the full protocol.

Full regimen details, sequencing, and clinical decision points are behind the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1182/blood.2020008739

Recurrent and often severe epistaxis is the most common manifestation of HHT, occurring in >90% of adults.
On the strength of this evidence, oral tranexamic acid is now recommended as an option for management of epistaxis that does not respond to moisturizing topical therapies alone.
Local ablative therapies for epistaxis: Laser treatment, Sclerotherapy, Electrosurgery, Radiofrequency ablation.

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