The Role of Topical Timolol in the Treatment of Infantile Hemangiomas: A Systematic Review and Meta-analysis

Abstract

To date the efficacy and safety of topical timolol in the treatment of infantile hemangioma has not been reviewed and analysed systematically. We collated all published data on the efficacy and safety of topical timolol in the treatment of infantile hemangioma. A total of 31 studies with 691 patients were included. The fixed effects pooled estimate of the response rate defined as any improvement from baseline of infantile hemangioma after treatment with topical timolol was significant (RR = 8.96; 95% CI 5.07-15.47; heterogeneity test p = 0.99), and the treatment was overall well tolerated. However, the quality of evidence was low to moderate. Topical timolol is an effective treatment for small infantile hemangioma, with no significant adverse effects noted. However, there is still a need for adequately powered randomised controlled trials.

Management of infantile hemangiomas during the COVID pandemic

“…Topical timolol is efficacious for smaller, thin IH. 17,19,20 Although rigorous safety studies have not been performed, if used in small amounts, the rate of adverse events is very low. 19 Systemic absorption occurs to varying degrees measurable in both urine and plasma; plasma concentrations demonstrated to have measurable systemic β-blocking activity in adults have been reported.…”

Oral propranolol in the treatment of proliferating infantile haemangiomas: British Society for Paediatric Dermatology consensus guidelines

“…Our guidelines are limited to oral propranolol rather than whole treatment modalities, such as other systemic beta blockers, including nadolol and atenolol, and the topical beta blocker timolol . We accept that some aspects, such as the statement on generic propranolol, are U.K. specific, but we nevertheless hope the guidelines will help to standardize practice internationally.…”

Topical timolol maleate for treatment of tufted angioma

“…Timolol is a non-selective beta-blocker that has been suggested as a suitable treatment alternative for superficial infantile hemangiomas in a few studies. 5 Preparations include hydrogel and a 0.5% solution applied once to twice daily, but the only available topical formulation of timolol in China is TTM 0.5% ophthalmic solution. Given the known upregulation of vascular endothelial growth factor isoforms in TA, we hypothesize that TTM inhibits vascular growth in TA.…”