Evidence map›Paper›PMID 42550693›Full record

Observational studyAmerican journal of hematology2026

Systemic Bevacizumab for Severe Bleeding From Acquired Gastrointestinal Vascular Malformations.

Nardeen E Ayad, Jacob R Anderson, Bimalangshu Dey, Rebecca Karp Leaf, Andrew B Song, Hanny Al-Samkari

Abstract readObservational Study
In one paragraph

Observational study in American journal of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nardeen E AyadDivision of Pediatric Hematology/Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0002-1482-7792
Jacob R AndersonDepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Bimalangshu DeyDivision of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Rebecca Karp LeafHarvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9978-8779
Andrew B SongHarvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-6915-8733
Hanny Al-SamkariHarvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-6175-1383

Funding

Antiangiogenic Therapy to Reduce Bleeding and Improve Health-Related Quality of Life in Hereditary Hemorrhagic TelangiectasiaK23HL159313 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Hanny T Al-Samkari · 2022 to 2026
$999k
NHLBI NIH HHS K23 HL159313NHLBI NIH HHS K23HL159313
6 · The paper itself

Abstract

Acquired gastrointestinal vascular malformations not due to congenital disorders such as hereditary hemorrhagic telangiectasia are a common cause of chronic and acute hemorrhage, particularly in older adults. These lesions cause severe anemia, dependence on intravenous iron and/or red-cell transfusion, and recurring hospitalizations. Hemostatic procedures are temporizing and no standard treatment, including the somatostatin analogs, addresses the underlying angiogenic dysregulation driving vascular malformation formation and recurrence. Therefore, bevacizumab, an anti-VEGF-A monoclonal antibody, is a promising targeted therapeutic. In this observational cohort study, we analyzed 32 patients (median age 75 years, 44% female) with acquired gastrointestinal vascular malformations due to idiopathic angiodysplasia, chronic liver disease, or deficiencies of von Willebrand factor who were treated on a predefined institutional bevacizumab pathway. The median Hematologic Support Score (a composite endpoint integrating red-cell units transfused and elemental iron infused) improved from 15.04 (95% CI, 11.16-21.80) red-cell unit equivalents during 6 months pretreatment to 4.08 (4.00-8.00) during Months 1-6 of bevacizumab treatment (p < 0.001) and further to 0.00 (0.00-5.40) during months 7-12 (p < 0.001). Units of red cells transfused and quantity of elemental iron infused were analyzed independently; both significantly improved after bevacizumab initiation. Annualized hospitalization/ED visit rate improved from 3 (year before bevacizumab) to 1 (year after bevacizumab) (p = 0.01), and median hemoglobin improved by 3.1 g/dL after bevacizumab (p < 0.001). Proteinuria and hypertension occurred in 8 (25%) and 5 (16%) patients, respectively, leading to bevacizumab discontinuation in 3 (9%). In conclusion, bevacizumab is a novel, targeted therapeutic approach for acquired gastrointestinal vascular malformations that may be safe and effective.

Indexed as

Angiogenesis InhibitorsBevacizumabGastrointestinal HemorrhageVascular MalformationsAgedAged, 80 and overAngiodysplasiaCohort StudiesFemaleHumansLiver DiseasesMaleMiddle Agedvon Willebrand DiseasesAngiogenesis InhibitorsBevacizumabacquired vascular malformationacquired von Willebrand syndromeanemiaangiodysplasiaangiogenesisbevacizumabgastrointestinal bleedingiron deficiencyliver diseasevon Willebrand disease

Identifiers

PMID42550693
PMCPMC13540306

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.