Angiodysplasia medical therapy: Difference between revisions
Jump to navigation
Jump to search
Nikita Singh (talk | contribs) |
Nikita Singh (talk | contribs) No edit summary |
||
| Line 9: | Line 9: | ||
* Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures. | * Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures. | ||
* Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.<ref name="pmid11677198">{{cite journal| author=Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM | display-authors=etal| title=A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. | journal=Gastroenterology | year= 2001 | volume= 121 | issue= 5 | pages= 1073-9 | pmid=11677198 | doi=10.1053/gast.2001.28650 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11677198 }} </ref> However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.<ref name="pmid3488703">{{cite journal| author=Bronner MH, Pate MB, Cunningham JT, Marsh WH| title=Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial. | journal=Ann Intern Med | year= 1986 | volume= 105 | issue= 3 | pages= 371-4 | pmid=3488703 | doi=10.7326/0003-4819-105-3-371 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3488703 }} </ref> | * Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.<ref name="pmid11677198">{{cite journal| author=Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM | display-authors=etal| title=A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. | journal=Gastroenterology | year= 2001 | volume= 121 | issue= 5 | pages= 1073-9 | pmid=11677198 | doi=10.1053/gast.2001.28650 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11677198 }} </ref> However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.<ref name="pmid3488703">{{cite journal| author=Bronner MH, Pate MB, Cunningham JT, Marsh WH| title=Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial. | journal=Ann Intern Med | year= 1986 | volume= 105 | issue= 3 | pages= 371-4 | pmid=3488703 | doi=10.7326/0003-4819-105-3-371 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3488703 }} </ref> | ||
* Thalidomide inhibits angiogenesis by inhibiting vascular endothelial growth factor (VEGF)- and basic fibroblast growth factor (bFGF)-induced angiogenesis.<ref name="pmid19576118">{{cite journal| author=Chen HM, Ge ZZ, Liu WZ, Lu H, Xu CH, Fang JY | display-authors=etal| title=[The mechanisms of thalidomide in treatment of angiodysplasia due to hypoxia]. | journal=Zhonghua Nei Ke Za Zhi | year= 2009 | volume= 48 | issue= 4 | pages= 295-8 | pmid=19576118 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19576118 }} </ref> It has been reported to be effective in the management of chronic bleeding from angiodysplasia as well as reduction in the number and size of lesions in numerous. | * Thalidomide inhibits angiogenesis by inhibiting vascular endothelial growth factor (VEGF)- and basic fibroblast growth factor (bFGF)-induced angiogenesis.<ref name="pmid19576118">{{cite journal| author=Chen HM, Ge ZZ, Liu WZ, Lu H, Xu CH, Fang JY | display-authors=etal| title=[The mechanisms of thalidomide in treatment of angiodysplasia due to hypoxia]. | journal=Zhonghua Nei Ke Za Zhi | year= 2009 | volume= 48 | issue= 4 | pages= 295-8 | pmid=19576118 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19576118 }} </ref> It has been reported to be effective in the management of chronic bleeding from angiodysplasia as well as reduction in the number and size of lesions in numerous.<ref name="pmid17179574">{{cite journal| author=Heidt J, Langers AM, van der Meer FJ, Brouwer RE| title=Thalidomide as treatment for digestive tract angiodysplasias. | journal=Neth J Med | year= 2006 | volume= 64 | issue= 11 | pages= 425-8 | pmid=17179574 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17179574 }} </ref><ref name="pmid19816627">{{cite journal| author=Almadi M, Ghali PM, Constantin A, Galipeau J, Szilagyi A| title=Recurrent obscure gastrointestinal bleeding: dilemmas and success with pharmacological therapies. Case series and review. | journal=Can J Gastroenterol | year= 2009 | volume= 23 | issue= 9 | pages= 625-31 | pmid=19816627 | doi=10.1155/2009/862816 | pmc=2776553 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19816627 }} </ref><ref name="pmid19730385">{{cite journal| author=Kamalaporn P, Saravanan R, Cirocco M, May G, Kortan P, Kandel G | display-authors=etal| title=Thalidomide for the treatment of chronic gastrointestinal bleeding from angiodysplasias: a case series. | journal=Eur J Gastroenterol Hepatol | year= 2009 | volume= 21 | issue= 12 | pages= 1347-50 | pmid=19730385 | doi=10.1097/MEG.0b013e32832c9346 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19730385 }} </ref><ref name="pmid17058171">{{cite journal| author=Bauditz J, Lochs H, Voderholzer W| title=Macroscopic appearance of intestinal angiodysplasias under antiangiogenic treatment with thalidomide. | journal=Endoscopy | year= 2006 | volume= 38 | issue= 10 | pages= 1036-9 | pmid=17058171 | doi=10.1055/s-2006-944829 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17058171 }} </ref> | ||
* <br /> | * <br /> | ||
Revision as of 04:47, 15 October 2021
|
Angiodysplasia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Angiodysplasia medical therapy On the Web |
|
American Roentgen Ray Society Images of Angiodysplasia medical therapy |
|
Risk calculators and risk factors for Angiodysplasia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]
Overview
Treatment is not required for incidentally found, asymptomatic, non-bleeding lesions. However, it is considered for non-bleeding angiodysplasia with symptoms of occult or overt GI bleed. The invasiveness of therapy depends on clinical severity of anemia, hemodynamic stability and recurrence of symptoms. Although endoscopic techniques are the first choice, hormonal therapy, thalidomide and octreotide are the pharmacological options that have been tried for patients with significant co-morbidities who cannot undergo invasive procedures.
Medical Therapy
- Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures.
- Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.[1] However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.[2]
- Thalidomide inhibits angiogenesis by inhibiting vascular endothelial growth factor (VEGF)- and basic fibroblast growth factor (bFGF)-induced angiogenesis.[3] It has been reported to be effective in the management of chronic bleeding from angiodysplasia as well as reduction in the number and size of lesions in numerous.[4][5][6][7]
References
- ↑ Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM; et al. (2001). "A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia". Gastroenterology. 121 (5): 1073–9. doi:10.1053/gast.2001.28650. PMID 11677198.
- ↑ Bronner MH, Pate MB, Cunningham JT, Marsh WH (1986). "Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial". Ann Intern Med. 105 (3): 371–4. doi:10.7326/0003-4819-105-3-371. PMID 3488703.
- ↑ Chen HM, Ge ZZ, Liu WZ, Lu H, Xu CH, Fang JY; et al. (2009). "[The mechanisms of thalidomide in treatment of angiodysplasia due to hypoxia]". Zhonghua Nei Ke Za Zhi. 48 (4): 295–8. PMID 19576118.
- ↑ Heidt J, Langers AM, van der Meer FJ, Brouwer RE (2006). "Thalidomide as treatment for digestive tract angiodysplasias". Neth J Med. 64 (11): 425–8. PMID 17179574.
- ↑ Almadi M, Ghali PM, Constantin A, Galipeau J, Szilagyi A (2009). "Recurrent obscure gastrointestinal bleeding: dilemmas and success with pharmacological therapies. Case series and review". Can J Gastroenterol. 23 (9): 625–31. doi:10.1155/2009/862816. PMC 2776553. PMID 19816627.
- ↑ Kamalaporn P, Saravanan R, Cirocco M, May G, Kortan P, Kandel G; et al. (2009). "Thalidomide for the treatment of chronic gastrointestinal bleeding from angiodysplasias: a case series". Eur J Gastroenterol Hepatol. 21 (12): 1347–50. doi:10.1097/MEG.0b013e32832c9346. PMID 19730385.
- ↑ Bauditz J, Lochs H, Voderholzer W (2006). "Macroscopic appearance of intestinal angiodysplasias under antiangiogenic treatment with thalidomide". Endoscopy. 38 (10): 1036–9. doi:10.1055/s-2006-944829. PMID 17058171.