Treatments for infantile Hemangioma: A systematic review and network meta-analysis

Fei, Qiang; Lin, Yu Huei; Chen, Xian

doi:10.1016/j.eclinm.2020.100506

Cited by 16 publications

(21 citation statements)

References 31 publications

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“… 41 Applying the same analytic method, combination therapies were analysed in a different study. 42 Topical beta-blockers with laser therapy were more effective than oral propranolol combined with laser therapy. Both combinations were more effective than monotherapy with 3 mg/kg/day oral propranolol or other therapies.…”

Section: Reviewmentioning

confidence: 99%

“…Multiple network meta-analyses have been published in recent years, providing insight into the relative effectiveness and safety of numerous IH treatment options. 41 , 42 , 88 Based on cluster analyses, oral propranolol was most effective, followed by IL corticosteroids and topical beta-blockers. On the other hand, topical beta-blockers were the safest, followed by IL propranolol and oral propranolol.…”

Section: Reviewmentioning

confidence: 99%

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Paediatrics: how to manage infantile haemangioma

Kim¹,

Lam²

2021

DIC

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Infantile haemangiomas (IHs) are relatively common benign vascular tumours found in the paediatric population. They have varying sizes and involve different depths in the skin leading to various colours, shapes and textures. Although considered harmless in most cases, they may lead to life-threatening complications or cause permanent disfigurations and organ dysfunction. For problematic IHs, the treatment options include oral and topical beta-blockers, systemic corticosteroids, laser treatment, and surgery. In this narrative review, the treatment options for problematic IH are compared and delivered concisely to facilitate the clinical decisions from practitioners, including those in primary care settings. Oral propranolol is currently considered the first-line intervention for problematic IHs. For superficial lesions, there is robust evidence for the use of topical timolol maleate. Systemic corticosteroids are sometimes used in specific situations such as resistance or contraindications to beta-blockers. Surgical excision can be considered in cases requiring urgent intervention such as airway obstruction; this can be done alongside laser therapies for the removal of residual tissue or when reconstructing areas of deformity. The combination of multiple treatment modalities may lead to a more rapid clinical response.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Paediatrics: how to manage infantile haemangioma

Kim¹,

Lam²

2021

DIC

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“…For most IH cases, the involution begins at 12 mo and finalizes by age 4[ 2 ]. Although a large portion of IHs tend to fade spontaneously without structural or aesthetics challenges, some are accompanied by vital complications or residual disfigurement[ 3 ]. In such cases, early intervention is critical for restraining the lesion growth, reducing the risk of complications, and mitigating psychosocial stress[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…IH intervention approaches involve medications and laser treatments, while surgery is required for patients who fail to respond to pharmacotherapy[ 2 , 3 ]. Orally administrated propranolol or topical applied timolol, as β-adrenergic blockers, have shown clear efficacy on the superficial IHs[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Itraconazole therapy for infant hemangioma: Two case reports

Liu

Wang

et al. 2021

WJCC

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BACKGROUND Infantile hemangiomas (IHs) are the most common childhood benign tumors, showing distinctive progression characteristics and outcomes. Due to the high demand for aesthetics among parents of IH babies, early intervention is critical in some cases. β-Adrenergic blockers and corticosteroids are first-line medications for IHs, while itraconazole, an antifungal medicine, has shown positive results in recent years. CASE SUMMARY In the present study, itraconazole was applied to treat two IH cases. The therapeutic course lasted 80-90 d, during which the visible lesion faded by more than 90%. Moreover, no obvious side effects were reported, and the compliance of the baby and parents was desirable. CONCLUSION Although these outcomes further support itraconazole as an effective therapeutic choice for IHs, large-scale clinical and basic studies are still warranted to improve further treatment.

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“…Despite the fact that most hemangiomas do not cause considerable problems, a significant part of them can lead to the appearance of permanent deformities of soft tissues or functional disorders, especially when localized on the face and vital structures [17,18]. The presence or consequences of hemangiomas can affect the quality of life of both children and their parents due to anxiety, low self-esteem of children and peer bullying due cosmetic defects [19].…”

Section: Introductionmentioning

confidence: 99%

Influence of Age and Morphological Features on the Clinical Manifestations and Treatment Efficacy of Hemangiomas in Children

Vivcharuk

Davydenko

2021

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Background. Infantile hemangioma (IH) is a neoplasm that is most common in childhood. Morphologically, hemangiomas are divided into superficial, deep and mixed, focal, segmental, indeterminate and multifocal. The course of IH includes phases of rapid growth followed by slow involution. The degree of involution of hemangioma is variable. Hemangiomas can lead to the appearance of permanent deformities of soft tissues or functional disorders, especially when localized on the face and vital structures. Clinical heterogeneity of hemangiomas creates significant difficulties for physicians in resolving issues of treatment tactics. Specific characteristics of the clinical behavior of hemangiomas of various morphological types can be crucial in the choice of management tactics for such patients. Objectives. The aim of the work is to study the effect of different morphological types of hemangioma in children on the effectiveness of treatment of age-related clinical features. Subjects and Methods. The study group consisted of 100 children in age from birth to 6 years who have hemangiomas of different morphological types and localizations and did not receive previous treatment. All research participants for hemangioma severity scale (HSS), hemangioma activity scale (HAS), visual analogue scale (VAS) before, during and after treatment were scored. Serum levels sFas/sFasLs before and during treatment evaluated. Results. With increasing the child’s age, the indicator as for HAS reliably decreases for all types of hemangiomas. In all types of hemangiomas predominantly an active growth took place. An abortive growth in 10% of patients was noted. For focal hemangiomas, the indicator of sFas decreases with age, and for multifocal hemangiomas it increases. In both cases, there is an increase in the sFasL indicator with increasing age of the child. In our study, in age group before 1 year in the factor structures, “age” factor was considered to be the main one and manifested by a decrease in the activity of hemangioma with an increase in the age of the child. Among children over 1 year age, during the course of treatment, the greatest contribution the “hemangioma severity factor”, the influence of which leads to a decrease in the cosmetic effect of hemangioma treatment against the background of its high severity and an increase in the indicator of apoptosis inhibition of sFas. The influence of the “treatment efficacy” factor leads to a decrease in its cosmetic effect and an increase in the severity of the manifestations of hemangioma against the background of blocking the manifestations of apoptosis. Conclusions. When starting treatment of hemangioma in the early stages, the cosmetic effect increases significantly. A decrease in sFasL in the younger age group may indicate a decrease or absence of apoptosis processes, which is clinically expressed by active proliferation. An increase in sFas in the older age group (over a year old) may indicate a blockage of apoptosis processes and, as a consequence, a slow regression of hemangioma.

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Treatments for infantile Hemangioma: A systematic review and network meta-analysis

Cited by 16 publications

References 31 publications

Paediatrics: how to manage infantile haemangioma

Paediatrics: how to manage infantile haemangioma

Itraconazole therapy for infant hemangioma: Two case reports

Influence of Age and Morphological Features on the Clinical Manifestations and Treatment Efficacy of Hemangiomas in Children

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