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.

中文翻译：

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脑动静脉畸形药物更新

尽管脑动静脉畸形 (bAVM) 有多种治疗选择，但许多病变的治疗仍然具有挑战性，并且存在显着的持续出血风险。最近的体外研究使人们对 bAVM 的形成、生长和破裂有了更深入的了解。这反过来又导致了 bAVM 药物治疗靶点的开发，其中一些已经开始在人体临床试验中进行测试。这些包括贝伐单抗，靶向血管内皮生长因子驱动的血管生成途径；沙利度胺或来那度胺，针对血脑屏障受损；和多西环素，靶向基质金属蛋白酶过表达。各种其他药物似乎很有前景，但要么需要适应其他疾病状态，要么需要从早期的实验室研究发展到临床领域。本综述旨在概述针对 bAVM 的药物开发的现状，并强调它们在未来可能的应用。