The Efficacy and Safety of Topical β-Blockers in Treating Infantile Hemangiomas: A Meta-Analysis Including 11 Randomized Controlled Trials

Wang, Xinhui; Feng, Wei; Xing, Zhao; Liu, Ziyu; Li, Dong

doi:10.1159/000510029

Cited by 15 publications

(22 citation statements)

References 31 publications

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“…Ariwibowo, Danarti et al and associates found that Timolol maleate 0.5% the answer was better than corticosteroids in reducing the dimensions of superficial IH. 10,14,[17][18][19][20][21][22][23][24] Our study also showed reduction in size,colour and shape of superficial infantile hemangiomas in approximately 08-12 weeks after the initiation of treatment.…”

Section: A H E a D O F P R I N Tsupporting

confidence: 68%

Role of topical beta blockers in regression of infantile capillary hemangioma

Junejo

Rebecca²,

Memon³

et al. 2021

Pak J Med Sci

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Objective: To observe efficacy of Timolol maleate 0.5% by topical and surface application in infantile superficial capillary hemangioma of eyelid. Methods: This multi-centered clinical case series was carried out at Ophthalmology Department of Bilawal Medical College and Institute of Ophthalmology, LUMHS, Jamshoro from November 2019 to May 2020. We included 14 subjects. All the patients were subjected to detailed clinical examination. Before starting the topical beta blockers, the enrolled subjects had obtained the expert opinion by pediatrician to rule out any preexisting developmental cardio vascular disease. Topical beta blockers 0.5% drops were thus started with, against the ongoing finding of superficial capillary hemangioma of eyelid. Results: There was significant regression in size of infantile hemangioma after treating with topical timolol maleate 0.5%. We included 14 subjects in this study. Mean±SD age of patients was 4.94. Complete regression was seen in 08 subjects at the end of 12 weeks (64%) while 03 were completely cured at 08 weeks (21%) and 01 patient lost follow up with us. No significant ocular and systemic side effects were noted. Conclusion: Topical timolol maleate 0.5% can be the first-line treatment modality for superficial capillary hemangiomas due to its better safety and efficacy. doi: https://doi.org/10.12669/pjms.37.7.4317 How to cite this:Junejo MS, Rebecca, Memon MN, Shaikh SP. Role of topical beta blockers in regression of infantile capillary hemangioma. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4317 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: A H E a D O F P R I N Tsupporting

confidence: 68%

Role of topical beta blockers in regression of infantile capillary hemangioma

Junejo

Rebecca²,

Memon³

et al. 2021

Pak J Med Sci

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“…Several reports have described similar outcomes using topical beta-blockers for the treatment of superficial periocular IH and two large recent meta-analyses, involving 1235 and 2098 children, concluded that topical beta-blockers may replace oral propranolol as first-line treatment for superficial IH due to its comparable effectiveness and reduced adverse effects [8,9].…”

Section: Discussionmentioning

confidence: 92%

Topical Timolol for Infantile Haemangioma of the Orbit

Hildebrand

Sipkova

2021

Klin Monbl Augenheilkd

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Infantile haemangiomas (IHs) are the most common benign tumours of the eyelid and orbits in infancy. Beta-blockers, in the form of oral propranolol, have become first-line treatment in severe cases with functionally significant or disfiguring IH. However, adverse drug reactions of oral propranolol in infants are reported in 1 in 11 and serious or potentially life-threatening systemic side effects in 1 in 38, including dyspnoea, hypotension, hyperkalaemia, hypoglycaemia, and cyanosis, therefore requiring careful and close monitoring during the course of systemic treatment. More recently, two large meta-analyses have shown topical beta-blockers, such as timolol maleate 0.5%, to be as effective as oral propranolol in superficial IH, but with no or significantly fewer adverse effects, and have advocated that topical beta-blockers replace oral propranolol as the first-line treatment of superficial IH. We have previously reported the therapeutic response of deep periocular IH to primary topical timolol maleate 0.5% monotherapy. Here we also describe the first successful treatments of large orbital IHs with primary topical timolol maleate 0.5% monotherapy in four infants, resulting in immediate cessation of progression and rapid clinical improvement or resolution in all cases. No adverse effects and no recurrence during long-term follow-up of up to 2.5 years after cessation were seen in any of the patients treated with topical timolol maleate 0.5%.

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“…Oral propranolol and topical beta-blockers are an established treatment for proliferating infantile hemangiomas due to vasoconstrictive and angiogenesis-inhibiting effects. 3 , 4 Similarly, there are case reports of propranolol improving other vascular diseases such as arteriovenous malformations, 3 cavernous hemangioma, 5 angiolymphoid hyperplasia with eosinophilia, 6 pyogenic granuloma, 7 angiosarcoma, 8 KS, 9 and other reactive angiomatoses (reactive angioendotheliomatosis and graft-versus-host disease-associated angiomatosis). 4 Regression of classic KS lesions treated with topical β-blocker has been noted.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 4 Similarly, there are case reports of propranolol improving other vascular diseases such as arteriovenous malformations, 3 cavernous hemangioma, 5 angiolymphoid hyperplasia with eosinophilia, 6 pyogenic granuloma, 7 angiosarcoma, 8 KS, 9 and other reactive angiomatoses (reactive angioendotheliomatosis and graft-versus-host disease-associated angiomatosis). 4 Regression of classic KS lesions treated with topical β-blocker has been noted. 10 Propranolol can be employed to treat a wide range of abnormal vascular changes similar to PKS, such as proliferating infantile hemangioma and other vascular diseases.…”

Section: Discussionmentioning

confidence: 99%