Nasal sprays have been found to be non-effective in reducing the duration and frequency of nosebleeds caused by a blood vessel disorder known as hereditary hemorrhagic telangiectasia (HHT). Two studies published in JAMA looked at the effectiveness of nasal sprays in HHT, which is an inherited condition that increases a person’s risk of bleeding.
Nosebleeds, or epistaxis, are a common symptom of HHT, and there is currently no medical treatment—medicinal or surgical—to treat nosebleeds in patients with HHT. The problem is that for people living with HHT, even something as simple as a nosebleed can be life threatening.
The study randomly assigned HHT patients to groups that either received a placebo or a nasal spray known as bevacizumab. The nasal spray was to be administered three times a day, fourteen days apart, over the course of four weeks.
The average monthly nosebleeds experienced between either groups was not significantly different. The nasal spray treatment has no measurable effects on the frequency of epistaxis, quality of life, number of red blood cell transfusion, or red blood cell and iron levels.
In the second clinical trial, 121 participants with HHT or HHT-related nosebleeds were included. Patients were randomly assigned to receive twice daily nasal sprays or a placebo. The researchers did not uncover any significant reductions in nosebleeds by using the nasal sprays. Similar to the first study, there were also no differences between the placebo group of the nasal spray group in regards to quality of life, duration and frequency or nosebleeds, or red blood cell and iron levels.
The two studies go to show that nasal sprays do not reduce the duration or the frequency of nosebleeds in hereditary hemorrhagic telangiectasia. Doctor’s should consider other modes of treatment for their patients.
Whitehead, K. J., et. al., “Effect of Topical Intranasal Therapy on Epistaxis Frequency in Patients With Hereditary Hemorrhagic Telangiectasia: A Randomized Clinical Trial,” JAMA, doi:10.1001/jama.2016.11724. http://jama.jamanetwork.com/article.aspx?articleid=2547755, last accessed September 7, 2016.