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This retrospective observational study evaluated oral propranolol in 151 adults with HHT using institutional registry data (44 treated, 107 untreated). After inverse probability of treatment weighting adjustment, propranolol was linked to significantly lower epistaxis frequency, with no clear effect on bleeding intensity.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/propranolol-reduces-epistaxis-in-hereditary-hemorrhagic-telangiectasia-a-large-retrospective-study/461559/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/propranolol-reduces-epistaxis-in-hereditary-hemorrhagic-telangiectasia-a-large-retrospective-study/461559.png","ImageObject",300,407,{"name":92,"@type":93},"kopisore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main purpose of the study?","Question",{"text":112,"@type":113},"To evaluate whether oral propranolol reduces nasal bleeding (epistaxis) in patients with hereditary hemorrhagic telangiectasia (HHT).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was epistaxis improvement measured?",{"text":117,"@type":113},"Outcomes at 6 months included changes in epistaxis frequency and intensity, assessed using the Sadick–Bergler scale, along with related clinical and adherence measures.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find about frequency and intensity of epistaxis?",{"text":121,"@type":113},"After IPTW adjustment, propranolol was significantly associated with reduced epistaxis frequency, while no effect was observed on intensity.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461559,1791076700,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Article  \nPropranolol Reduces Epistaxis in Hereditary Hemorrhagic Telangiectasia: A Large Retrospective Study  \nMarcelo Martín Serra 1, *, Vanina Pagotto 2, Luisa Maria Botella 3,4 and Carmelo Bernabeu 3  \nAcademic Editor: KikuoIsoda  \nReceived: 29 October 2025  \nRevised: 15 December 2025  \nAccepted: 25 December 2025  \nPublished: 4 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 HHT Unit, Argentine Rendu Study Group (ARG), Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires C1199ABB, Argentina  \n2 Argentine Rendu Study Group (ARG), Research Department, Hospital Italiano de Buenos Aires, Buenos Aires C1199ABB, Argentina; [vanina.pagotto@hospitalitaliano.org.ar](vanina.pagotto@hospitalitaliano.org.ar)  \n3 Center for Biological Research “Margarita Salas”, Spanish National Research Council (CSIC),  \n28040 Madrid, Spain; [cibluisa@cib.csic.es](cibluisa@cib.csic.es) (L.M.B.); [bernabeu.c@cib.csic.es](bernabeu.c@cib.csic.es) (C.B.)  \n4 Spanish National Network for Research on Rare Diseases (CIBERER), 28029 Madrid, Spain  \n* [Correspondence: marcelo.serra@hospitalitaliano.org.ar](Correspondence: marcelo.serra@hospitalitaliano.org.ar)  \nAbstract  \nBackground/Objectives: Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant vascular dysplasia characterized by recurrent epistaxis, anemia, and visceral arteriovenous malformations. Epistaxis is the most frequent and disabling manifestation, with limited effective pharmacological options. Propranolol, a non-selective beta-blocker with vasoconstrictive and antiangiogenic properties, has shown benefit in other vascular anomalies but remains scarcely studied in HHT. This study aimed to evaluate the effect of oral propranolol on nasal bleeding in patients with HHT. Methods: A retrospective observational study including 151 adults with HHT (44 treated with propranolol, 107 untreated) was conducted using data from an Institutional HHT Registry from a referral center. Baseline demographic and clinical variables were recorded. Outcomes at 6 months included changes in hemoglobin, adherence to nasal hygiene, use of bleeding-related therapies, and improvement in epistaxis frequency and intensity according to the Sadick–Bergler scale. Logistic regression models were adjusted for confounders and indication bias using inverse probability of treatment weighting (IPTW) . Results: After IPTW adjustment, propranolol was significantly associated with reduced frequency of epistaxis (adjusted OR: 3.8; 95% CI: 1.3–11.2; p = 0.016), while no effect was observed on intensity. Hemoglobin levels increased modestly in both groups without a significant difference. Patients without propranolol showed greater antifibrinolytic use, whereas adherence to nasal care remained stable among treated patients. Conclusions: Oral propranolol reduced nasal bleeding frequency in HHT, even among patients with greater baseline severity. Given its accessibility, safety, and potential to lessen treatment burden, it may represent a valuable adjunct therapy. This study represents the largest cohort of HHT patients treated with propranolol reported to date. Randomized trials including standardized bleeding scores and patient-reported outcomes are warranted to confirm clinical and quality-of-life benefits.  \nKeywords: angiogenesis; adrenergic beta-antagonists; epistaxis; HHT; nasal hemorrhage  \n1. Introduction  \nHereditary Hemorrhagic Telangiectasia (HHT), also known as Osler–Weber–Rendu disease, is an autosomal dominant vascular dysplasia [1,2] with an estimated prevalence of 1 in 5000 individuals [3,4] . It is caused by mutations in components of the  \nBMP/ENG/ALK1/Smad4 signaling pathway, which play a key role in angiogenesis [5] . Clinically, HHT is characterized by telangiectasias affecting the skin and mucosal surfaces, pa","cbCaibcCck8GiIkf","https://ap.wps.com/l/cbCaibcCck8GiIkf","pdf",2632980,21,"English","# Introduction\n## Background on HHT and epistaxis\n## Current management strategies and treatment gaps\n## Rationale for propranolol\n# Methods\n## Study design and population\n## Outcomes and follow-up\n## Statistical approach","[{\"question\":\"What is the main purpose of the study?\",\"answer\":\"To evaluate whether oral propranolol reduces nasal bleeding (epistaxis) in patients with hereditary hemorrhagic telangiectasia (HHT).\"},{\"question\":\"How was epistaxis improvement measured?\",\"answer\":\"Outcomes at 6 months included changes in epistaxis frequency and intensity, assessed using the Sadick–Bergler scale, along with related clinical and adherence measures.\"},{\"question\":\"What did the study find about frequency and intensity of epistaxis?\",\"answer\":\"After IPTW adjustment, propranolol was significantly associated with reduced epistaxis frequency, while no effect was observed on intensity.\"}]","Propranolol Reduces Epistaxis in Hereditary Hemorrhagic Telangiectasia - A Large Retrospective Study | PDF",1790761877,53]