Clinical efficacy and safety of two different hematoporphyrin monomethyl ether‐mediated photodynamic therapy regimen in Chinese children with <scp>port‐wine</scp> stain

Zhang, Sheng; Wang, Xiuwei; Chen, Hongguang; Cao, Huina; Zhang, Hongli; Yang, Ming; Zhu, Yan; Qin, Qin; Liu, Xiaoyan; Wang, Jianhua; Zhang, Gaolei

doi:10.1111/exd.14834

Cited by 2 publications

(2 citation statements)

References 42 publications

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“…This process spares the normal epidermal layer lacking HMME and normal dermal tissue beyond the reach of the laser. 6,20 In this trial, we treated 33 cases of PWS with HMME-PDT. The overall response rate after HMME-PDT was 90.90%.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Observation on the Therapeutic Effect of Port-Wine Stains with Intravenous Injection of Hematoporphyrin Monomethyl Ether (HMME)

Ning,

Wang,

Liu

et al. 2024

CCID

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Background: Hematoporphyrin monomethyl ether (HMME) is a promising photosensitizer for photodynamic therapy (PDT) and has found wide application in the treatment of port-wine stains (PWS).Objective: This study aims to observe and analyze the clinical efficacy and safety of HMME-PDT in the treatment of PWS patients. It also aims to evaluate the usefulness of color Doppler flow imaging (CDFI), an ultrasound technique for detecting blood flow in skin lesions, in assessing clinical efficacy. Methods: Thirty-three patients with PWS underwent HMME-PDT at our dermatology outpatient clinic between January 2019 and March 2020. Data on patient demographics, lesion location, lesion type (pink, purple, nodular thickening), treatment frequency, and pre-and post-treatment images were collected and retrospectively analyzed. CDFI was performed on three patients. Results: All patients received intravenous HMME and underwent irradiation with 532 nm green LED light. Of these, 5 patients received 1 session of HMME-PDT, 14 received 2 sessions, 9 received 3 sessions and the remaining 5 patients received more than 3 sessions. Of the 33 patients, 9 were cured (27.27%), 10 showed improvement (30.30%), 11 experienced a reduction in symptoms (33.33%), and 3 showed no significant improvement (9.09%). Most patients reported local pain and oedema, and no systemic adverse effects were observed. Clinical efficacy correlated with lesion type and total number of treatment sessions. CDFI appears to be an excellent technique for assessing clinical efficacy. Conclusion: HMME-PDT is a safe and effective method for the treatment of PWS. CDFI examination appears to be a promising assessment tool. However, further validation with larger sample sizes is warranted.

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Section: Discussionmentioning

confidence: 99%

“…HMME-PDT is generally considered safe for the treatment of nevus erythematosus, with studies showing that both fast-and slow-dosing regimens are effective and safe in treating Chinese children with this condition. 7,20 However, adverse reactions may still occur during treatment. Contraindications may vary depending on the clinical scenario.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation on the Therapeutic Effect of Port-Wine Stains with Intravenous Injection of Hematoporphyrin Monomethyl Ether (HMME)

Ning,

Wang,

Liu

et al. 2024

CCID

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Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

Gao,

Nguyen,

Hochman

et al. 2024

Lasers Surg Med

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BackgroundPort wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the “gold standard” for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)‐mediated photodynamic therapy (HMME–PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades.AimTo evaluate whether HMME–PDT is superior to PDL by comparing the clinical efficacies of both modalities.MethodPubMed records were searched for all relevant studies of PWB treatment using PDL (1988−2023) or HMME–PDT (2007−2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C0), with data weighted by cohort size, was used to evaluate the final efficacy for each modality.ResultA total of 18 HMME–PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME‐PDT studies were minors (<18 years old). A significant portion (21.3%) were young children (<3 years old). Similarly, 33.2% of patients in the PDL studies were minors. A small proportion (9.3%) was young children. The overall clearance rates for PDL were slightly, but not significantly, higher than those for HMME–PDT in cohorts with patients of all ages (C0, 0.54 vs. 0.48, p = 0.733), subpopulations with only minors (C0, 0.54 vs. 0.46, p = 0.714), and young children (C0, 0.67 vs. 0.50, p = 0.081). Regrettably, there was a lack of long‐term data on follow‐up evaluations for efficacy and impact of HMME‐PDT on young children in general, and central nervous system development in particular, because their blood‐brain barriers have a greater permeability as compared to adults.ConclusionPDL shows overall albeit insignificantly higher clearance rates than HMME‐PDT in patients of all ages; particularly statistical significance is nearly achieved in young children. Collectively, current evidence is insufficient to support HMME–PDT as the first choice of treatment of PWBs in young children given: (1) overall inferior efficacy as compared to PDL; (2) risk of off‐target exposure to meningeal vasculature during the procedure; (3) administration of steriods for mitigation of side effects; ‐and (4) lack of long‐term data on the potential impact of HMME on central nervous system development in young children.

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Clinical efficacy and safety of two different hematoporphyrin monomethyl ether‐mediated photodynamic therapy regimen in Chinese children with port‐wine stain

Cited by 2 publications

References 42 publications

Clinical Observation on the Therapeutic Effect of Port-Wine Stains with Intravenous Injection of Hematoporphyrin Monomethyl Ether (HMME)

Clinical Observation on the Therapeutic Effect of Port-Wine Stains with Intravenous Injection of Hematoporphyrin Monomethyl Ether (HMME)

Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

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