Atenolol treatment for severe infantile hemangiomas: comparison with a propranolol group of our centre

Dakoutrou, Maria; Alexopoulos, A.; Miligkos, Michael; Georgiadou, E.; Kanaka‐Gantenbein, Christina; Kakourou, Talia

doi:10.1111/jdv.15464

Cited by 7 publications

(14 citation statements)

References 9 publications

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“…Simultaneously, the bibliographies of the studies retrieved were reviewed and 4 more relevant studies were identified. Finally, data from 8 studies with 608 participants satisfying the inclusion criteria were analysed (13,14,(22)(23)(24)(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

“…The two RCTs (13,27) included in the present meta-analysis had low risks of bias in almost all of the domains. Among the non-randomized studies (14,(22)(23)(24)(25)(26), all of the studies had a low risk of bias regarding selection of participants, intervention measures, incomplete outcome data and unclear risks of selective reporting of outcomes (protocols not published), or blinding of outcome assessment (not mentioned in the studies). Furthermore, three out of six studies had high risks of bias with respect to confounding variables.…”

Section: Resultsmentioning

confidence: 99%

“…Table I lists the characteristics of the studies analysed. Two studies were RCTs ( 13 , 27 ), 3 were prospective ( 23 , 25 , 26 ) and the remaining studies were retrospective studies ( 14 , 22 , 24 ). Most of the studies were performed in Asian countries [China (2 studies) ( 23 , 26 ) and India (1 study)] ( 27 ) and the others were performed in American and European countries.…”

Section: Resultsmentioning

confidence: 99%

“…Among the studies included, 6 reported on the response rate or reduction in the lesion size following intake of the medication in the two groups (atenolol and propranolol) (13,(22)(23)(24)(25)(26). Apart from the study by Wang et al (26), all of the other studies (13,14,(22)(23)(24)(25)27) indicated that propranolol was favoured, as it had a higher response rate when compared to the atenolol group. The overall pooled odds ratio (OR) in the propranolol arm was 1.36, indicating these infants had a 1.36 times greater odds of having complete response (reduction in lesion size) following the medication than those in the atenolol group (Fig.…”

Section: Hasmentioning

confidence: 99%

“…Adverse ef fects. A total of 6 studies repor ted on adverse effects following t he medication in t he (13,14,(23)(24)(25)27). Except for the studies by Ashraf et al (27) and Dakoutrou et al (25), all other studies reported that infants taking propranolol had a greater chance of developing adverse effects following medication when compared with infants taking atenolol.…”

Section: Hasmentioning

confidence: 99%

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Atenolol vs. propranolol for the treatment of infantile haemangiomas: A systematic review and meta‑analysis

Liu

Song

et al. 2020

Exp Ther Med

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Infantile haemangioma (IH) is a benign vascular tumour type that occurs in 3-10% of infants. In the present meta-analysis, previous studies comparing clinical outcomes, including the recovery rate and haemangioma activity score (HAS), adverse effects and relapse rates, were compared between patients treated with atenolol and those treated with propranolol for IH. A systematic search in various databases, including Medline, Cochrane Controlled Register of Trials, ScienceDirect and Google Scholar from inception until July 2019 was performed. The Cochrane risk of bias tool was used to assess the quality of published trials. A meta-analysis with a random-effects model and reported pooled mean differences (MD) or odds ratios (OR) with 95% CIs was performed. In total, 8 studies including 608 participants were analyzed. Only 2 studies were randomized controlled trials, while the majority of studies had low or unclear bias risks. Except for the response to medication (pooled OR=1.49; 95% CI, 0.85-2.18), all other outcomes (HAS, adverse reactions and relapse rate) were better for the atenolol group than the propranolol group. Atenolol resulted in better HAS (pooled MD=0.16; 95% CI,-0.42 to 0.73). Propranolol had more adverse reactions (pooled OR=2.17; 95% CI, 0.93-5.06) and a higher relapse rate (pooled OR, 1.67; 95% CI, 0.44-6.41) when compared to atenolol. However, these findings were not statistically significant. The results of this analysis suggest that atenolol may be non-inferior to propranolol and may offer advantages, including lower adverse reactions and relapse rates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Hasmentioning

confidence: 99%

Section: Hasmentioning

confidence: 99%

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Atenolol vs. propranolol for the treatment of infantile haemangiomas: A systematic review and meta‑analysis

Liu

Song

et al. 2020

Exp Ther Med

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Medical Management of Infantile Hemangiomas: An Update

Colmant

Powell

2021

Pediatr Drugs

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Should Propranolol Remain the Gold Standard for Treatment of Infantile Hemangioma? A Systematic Review and Meta-Analysis of Propranolol Versus Atenolol

Chen

Gudipudi

Nguyen

et al. 2022

Ann Otol Rhinol Laryngol

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Background: Although propranolol has been established as the gold standard when treatment is sought for infantile hemangioma, concerns over its side effect profile have led to increasing usage of atenolol, a beta-1 selective blocker. Methods: A systematic review of PubMed, Scopus, CINAHL, Google Scholar, and Cochrane was conducted following PRISMA guidelines using MeSH terms and keywords for the terms propranolol, atenolol, and infantile hemangioma, including alternative spellings. All randomized control trials (RCTs) or cohort studies directly comparing outcomes of hemangioma treatment with atenolol and propranolol were included. A meta-analysis with pooled mean differences, pooled odds ratios, and analysis of proportions was performed. Results: A total of 669 participants in 7 studies (3 RCTs and 4 cohort) were included. Propranolol showed a significantly higher rate of complete response compared to atenolol (73.3% vs 85.4%, P = .0004). The pooled mean difference of 0.07 (95% CI –0.12, 0.27) in Hemangioma Activity Score (HAS) was not statistically significant. In terms of side effects, there were significantly more agitation and bronchial hyperreactivity events in the propranolol group ( P = .0245 and P < .0001, respectively). Overall, there was a significantly greater number of adverse events in the propranolol group compared to the atenolol group (185 vs 117, P < .00001). The overall pooled odds ratio was 2.70 (95% CI 1.90, 3.84), indicating that there is 2.7 times higher odds of adverse events in the propranolol group. Conclusion: Propranolol treatment leads to a significantly higher rate of complete response than atenolol. However, its use must be weighed against its greater side effect profile.

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Atenolol treatment for severe infantile hemangiomas: comparison with a propranolol group of our centre

Cited by 7 publications

References 9 publications

Atenolol vs. propranolol for the treatment of infantile haemangiomas: A systematic review and meta‑analysis

Atenolol vs. propranolol for the treatment of infantile haemangiomas: A systematic review and meta‑analysis

Medical Management of Infantile Hemangiomas: An Update

Should Propranolol Remain the Gold Standard for Treatment of Infantile Hemangioma? A Systematic Review and Meta-Analysis of Propranolol Versus Atenolol

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