Clinical study on hemoporfin PDT for infant facial port-wine stains

Zhang, Yunjie; Yang, Yuguang; Zhang, Zhe; Yang, Yanjin; Meng, Qingcai; Chen, Hongxia; Li, Lei; Zou, Xianbiao

doi:10.1016/j.pdpdt.2018.09.012

Cited by 25 publications

(21 citation statements)

References 9 publications

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“…Vascular‐targeted PDT has been as an alternative and adjunctive treatment for PWS in China Recent phase IIa, IIb and III clinical trials of HMME‐mediated PDT have been completed, and showed a high level of clinical efficacy and minor adverse reactions in infant and pediatric patients . Yuan et al.…”

Section: Discussionmentioning

confidence: 99%

“…43 Vascular-targeted PDT has been as an alternative and adjunctive treatment for PWS in China 20,26 Recent phase IIa, IIb and III clinical trials of HMME-mediated PDT have been completed, 22,44,45 and showed a high level of clinical efficacy and minor adverse reactions in infant and pediatric patients. 24,25 Yuan et al 46 reported the case of a patient with light purple PWS lesions who did not respond to conventional PDL treatment (585 nm), but responded well to HMME-PDT. Another study indicated that PDT is highly efficacious in patients with treatment-resistant PWS lesions, 47 while the longterm outcomes of PDT were reported to be relatively stable.…”

Section: Discussionmentioning

confidence: 99%

“…Vascular‐targeted photodynamic therapy (PDT) has been used to treat PWS since the 1990s . In 1990, Orenstein et al.…”

Section: Introductionmentioning

confidence: 99%

“…6,18 Vascular-targeted photodynamic therapy (PDT) has been used to treat PWS since the 1990s. [19][20][21][22][23][24][25] In 1990, Orenstein et al used a chicken comb model to show that PDT can treat hypervascular dermal lesions while leaving the normal overlying epidermis completely intact. 19 The use of vascular-targeted PDT for treating PWS was first described in 1991.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective study of photodynamic therapy for pulsed dye laser‐resistant port‐wine stains

Han

Ying

Zhang

et al. 2020

The Journal of Dermatology

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Pulsed dye laser‐resistant port‐wine stains present a therapeutic challenge. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy for treating these lesions. A total of 67 patients with pulsed dye laser‐resistant cervicofacial port‐wine stains were retrospectively assessed after undergoing photodynamic therapy mediated with a combination of hemoporfin and 532‐nm light. For objective evaluation of photodynamic therapy efficacy, first, the colorimetric changes in the port‐wine stain lesions were evaluated according to the L*a*b* color coordinate system, then the values of color changes (ΔE) and blanching rate were calculated. For subjective evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the subjective evaluation. Adverse events were recorded after treatment. The median ΔE decreased significantly from the pretreatment value of 13.42 to 9.90 at the 2‐month follow up (P < 0.001). The median blanching rate of port‐wine stains was 28.04% after an average of 1.21 sessions of photodynamic therapy. Based on the overall visual assessment, 46.2% patients showed excellent or good levels of improvement (>50% color blanching). Adverse events were minimal, transient and self‐limiting. In conclusion, photodynamic therapy serves as an alternative means to treat pulsed dye laser‐resistant port‐wine stains.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Vascular‐targeted photodynamic therapy (PDT) has been used to treat PWS since the 1990s . In 1990, Orenstein et al.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Retrospective study of photodynamic therapy for pulsed dye laser‐resistant port‐wine stains

Han

Ying

Zhang

et al. 2020

The Journal of Dermatology

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“…7 PDT as a vascular-targeted approach to treat PWS has been used most commonly in China since the 1990s and has achieved substantial beneficial results. [8][9][10][11][12][13][14] PsD-007 (photocarcinorin), a mixed porphyrin preparation containing almost all the components of hematoporphyrin derivatives, including 3-(or 8-)-(1-hydroxyethyl)-8-(or 3-)-(1-methoxyethyl)-deuteroporphyrin (MHD), 3-(or 8-)-(1-methoxyethyl)-8-(or 3-)-vinyldeuteroporphyrin (MVD), 3-(or 8-) hydroxyethyl-8-(or 3-) vinyldeuteroporphyrin (HVD), di(1-methoxyethyl) deuteroporphyrin (DMD), hematoporphyrin (Hp), protoporphyrin (Pp), and other active substances, is a firstgeneration photosensitizer. 15 PsD-007-mediated PDT, combined with application of alternative light sources [including copper vapor laser or the potassium-titanyl phosphate (KTP) laser], appears to be a safe and effective approach for treating PWS; however, it is associated with prolonged systemic photosensitivity for at least 1 month and presents a significant scarring risk.…”

mentioning

confidence: 99%

Comparison of Two Generation Photosensitizers of PsD-007 and Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Treatment of Port-Wine Stain: A Retrospective Study

Han

Ying

et al. 2019

Photobiomodulation, Photomedicine, and Laser Surgery

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Objective: To compare the efficacy and safety of the two generation photosensitizers, PsD-007 and hematoporphyrin monomethyl ether (HMME), for photodynamic therapy (PDT) of port-wine stain (PWS). Background: Vascular-targeted PDT has shown potentially beneficial results in treating PWS; however, the efficacy and safety of various photosensitizers have not been fully investigated. Materials and methods: We retrospectively analyzed 38 patients with PWS, who were treated with one session of PsD-007-mediated (n = 21) or HMME-mediated (n = 17) PDT. Clinical efficacy was assessed by a chromameter and visual assessment of color blanching of the PWS lesion. Adverse events were evaluated. Results: Neither visual nor chromameter optical evaluations showed significant differences between the PsD-007 and HMME groups (p = 0.337 and p = 0.191, respectively). The total response rate was 76.2% (n = 16) in the PsD-007 group and 88.2% (n = 15) in the HMME group. Good or excellent clearance was achieved in 42.9% patients in the PsD-007 group and 29.4% patients in the HMME group. The average DE (color expressed change or improvement) and mean blanching rate measured optically were higher in the PsD-007 group than in the HMME group without statistical differences (8.51 vs. 7.39, p = 0.649; 0.37 vs. 0.29, p = 0.191). Incidences of swelling, pruritus, scab formation, and other adverse reactions were similar for the two groups. There were no blisters, scarring, or hypopigmentation in either group. Conclusions: Both PsD-007-and HMME-mediated PDTs are effective and safe for treatment of PWS. However, HMME has a shorter photosensitivity period than does PsD-007, which might be more recommended.

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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 study on hemoporfin PDT for infant facial port-wine stains

Cited by 25 publications

References 9 publications

Retrospective study of photodynamic therapy for pulsed dye laser‐resistant port‐wine stains

Retrospective study of photodynamic therapy for pulsed dye laser‐resistant port‐wine stains

Comparison of Two Generation Photosensitizers of PsD-007 and Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Treatment of Port-Wine Stain: A Retrospective Study

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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