Status:

COMPLETED

Timolol Gel for Epistaxis in Hereditary Hemorrhagic Telangiectasia

Lead Sponsor:

Washington University School of Medicine

Conditions:

Hereditary Hemorrhagic Telangiectasia

Eligibility:

All Genders

20+ years

Phase:

PHASE2

Brief Summary

This study is a double-blinded, randomized controlled trial to evaluate the efficacy of an intranasal topical timolol gel in the care for epistaxis in adults with hereditary hemorrhagic telangiectasia...

Detailed Description

This study is a double-blinded, placebo-controlled, 8-week randomized clinical trial investigating the efficacy of timolol gel in the management of epistaxis in adults with HHT. The Specific Aims are...

Eligibility Criteria

Inclusion

  • Adults ages 20 and older
  • Confirmed clinical (meeting at least 3 of the 4 Curaçao Criteria) or genetic diagnosis of HHT
  • Epistaxis Severity Score (ESS) ≥ 4 and 2 or more nosebleeds per week with a cumulative nosebleed duration of at least 5 minutes per week
  • Stable nasal hygiene and medical regimen for preceding 1 month
  • Stable epistaxis pattern over the preceding 3 months

Exclusion

  • Contraindications for systemic β adrenergic blocker administration
  • Hypersensitivity to β adrenergic blockers
  • Asthma or bronchospasm
  • Congestive heart failure with LVEF \<40%
  • Hereditary pulmonary arterial hypertension
  • Baseline bradycardia (HR \<55 beats per minute)
  • Sick Sinus Syndrome
  • 2nd or 3rd degree heart block, left or right bundle branch block, or bifasicular block
  • Uncontrolled diabetes mellitus (most recent HbA1c \>9%) or diabetic ketoacidosis within last 6 months
  • Hypotension (systolic blood pressure \< 90)
  • Known hypersensitivity to timolol
  • Severe peripheral circulatory disturbances (Raynaud phenomenon)
  • Known intermediate or poor metabolizer variant of the liver enzyme CYP2D6
  • Current use of any of the following known strong CYP2D6 inhibitors: fluoxetine (Prozac), paroxetine (Paxil), bupropion (Welbutrin), quinidine, quinine, ritonavir (Norvir), and terbinafine (Lamisil)
  • Current use of the following other drugs known to pharmacodynamically interact with timolol: diltiazem, verapamil, digoxin, digitalis, propafenone, disopyramide, clonidine, flecainide, or lidocaine
  • Patients currently treated or who plan to initiate treatment with β-blockers
  • Use of any anti-angiogenic medication in the last month prior to recruitment, including bevacizumab, pazopanib, thalidomide, or lenalidomide
  • Illicit drug use, except marijuana
  • Known pheochromocytoma
  • Use of anticoagulants, antiplatelet, or fibrinolytic therapies within the last month prior to recruitment, except for low-dose (81 mg or less) of aspirin
  • Pregnancy or planned pregnancy in the next 6 months or currently breastfeeding
  • Inability to read or understand English
  • Inability to complete 8 weeks of therapy for any reason

Key Trial Info

Start Date :

October 20 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

May 20 2020

Estimated Enrollment :

27 Patients enrolled

Trial Details

Trial ID

NCT04139018

Start Date

October 20 2019

End Date

May 20 2020

Last Update

August 24 2021

Active Locations (1)

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Washington University

St Louis, Missouri, United States, 63110