Preprint Brief Report Version 1 Preserved in Portico This version is not peer-reviewed

Tacrolimus as a Promising Drug for Epistaxis and Gastro Intestinal Bleeding in HHT

Paloma Alvárez-Hernández
,
José Luis Patier
ORCID logo ,
Sol Marcos
ORCID logo ,
Vicente Gómez del Olmo
,
Laura Lorente-Herraiz
,
Lucía Recio-Poveda
,
Luisa María Botella
ORCID logo ,
Adrián Viteri-Noël
* ,
Virginia Albiñana
*
Version 1 : Received: 7 November 2023 / Approved: 7 November 2023 / Online: 8 November 2023 (01:35:55 CET)

A peer-reviewed article of this Preprint also exists.

Álvarez-Hernández, P.; Patier, J.L.; Marcos, S.; Olmo, V.G.; Lorente-Herraiz, L.; Recio-Poveda, L.; Botella, L.M.; Viteri-Noël, A.; Albiñana, V. Tacrolimus as a Promising Drug for Epistaxis and Gastrointestinal Bleeding in HHT. J. Clin. Med. 2023, 12, 7410. Álvarez-Hernández, P.; Patier, J.L.; Marcos, S.; Olmo, V.G.; Lorente-Herraiz, L.; Recio-Poveda, L.; Botella, L.M.; Viteri-Noël, A.; Albiñana, V. Tacrolimus as a Promising Drug for Epistaxis and Gastrointestinal Bleeding in HHT. J. Clin. Med. 2023, 12, 7410.

Abstract

Background: Hereditary Hemorrhagic Telangiectasia (HHT) is a vascular autosomically inherited rare disease. Epistaxis (nose bleeds) is the most common symptom in HHT, leading to anemia and affecting patient’s quality of life. In addition to epistaxis, gastrointestinal bleeding (GI), more often at older ages, may lead to severe anemia and need for blood transfussions. Thus, finding drugs to control both types of bleeding is a primary necessity in HHT. Methods: A cross-sectional observational study was conducted in a series of 11 HHT patients treated with low tacrolimus doses (0.5-1mg) on an off-label prescription basis. Patients showed refractory bleeding to previous treatments. Epistaxis severity score (ESS) and hemoglobin levels were parameters used to evaluate tacrolimus impact. The occurrence of side effects was also recorded. Results: Tacrolimus was well tolerated in most of the patients, except in 2 which abandoned the treatment. The remaining patients tolerated the treatment, with a general improvement in their health condition. Epistaxis was significantly reduced comparing the ESS before and after treatment. Hemoglobin levels were significantly increased overcoming the anemia in the course of the treatment. Conclusion: Tacrolimus at low doses should be considered as a promising treatment for bleeding derived of epistaxis and GI in HHT.

Keywords

HHT; bleeding; epistaxis; GI bleeding; tacrolimus; ESS; Hemoglobin

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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