An Update on Medications for Brain Arteriovenous Malformations. Issue 5 (20th May 2020)

• Record Type: Journal Article
• Authors: Raper, Daniel M S; Winkler, Ethan A; Rutledge, W Caleb; Cooke, Daniel L; Abla, Adib A
• Is Part Of: Neurosurgery. Volume 87:Issue 5(2020)
• Page Start: 871
• Page End: 878
• Publication Date: 2020-05-20
• Subjects: Brain arteriovenous malformation -- Blood-brain barrier -- Hereditary hemorrhagic telangiectasia -- Intracerebral hemorrhage -- Vascular endothelial growth factor; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa192
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: Despite a variety of treatment options for brain arteriovenous malformations (bAVMs), many lesions remain challenging to treat and present significant ongoing risk for hemorrhage. In Vitro investigations have recently led to a greater understanding of the formation, growth, and rupture of bAVMs. This has, in turn, led to the development of therapeutic targets for medications for bAVMs, some of which have begun testing in clinical trials in humans. These include bevacizumab, targeting the vascular endothelial growth factor driven angiogenic pathway; thalidomide or lenalidomide, targeting blood-brain barrier impairment; and doxycycline, targeting matrix metalloproteinase overexpression. A variety of other medications appear promising but either requires adaptation from other disease states or development from early bench studies into the clinical realm. This review aims to provide an overview of the current state of development of medications targeting bAVMs and to highlight their likely applications in the future.