Determining Optimal Therapy to Control GI Bleeding
Deborah Proctor, M.D.,Associate Professor of Internal Medicine
Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder, more common in women than men and characterized by abnormal vascular bleeding in different organs - particularly the gastrointestinal (GI) tract, which results in the need for multiple blood transfusions for many years. In this pilot study, Dr. Proctor aimed to determine how the use of oral estrogen-progesterone hormone therapy could reduce bleeding and subsequent need for blood transfusions based on anecdotal clinical data suggesting hormonal therapy may act to induce wound healing.
Highlighted Study Findings
Dr. Proctor conducted this study to evaluate the use of combination estrogen/progesterone hormone therapy to control GI tract bleeding with HHT. At the time this study was proposed, YNHH was a referral center for this disorder, however immediately after funding, this pattern changed preventing Dr. Proctor from enrolling multiple subjects as planned. Nonetheless, Dr. Proctor studied and published the data on a case study demonstrating promise for this therapy in a 51-year-old woman with HHT who had severe anemia and GI bleeding. The patient entered the study and received Ovcon 50, a high-dose combination hormone pill. Over the course of four months, the woman’s transfusion requirements decreased markedly. As a result of treatment, she no longer needed blood transfusions. Although this was a single patient, the case demonstrated that hormone therapy may be successful in some patients with HHT and GI bleeding.