AIMS: To evaluate the effectiveness and safety of topical β-receptor blocker in treating superficial infantile haemangiomas (SIH) and compare the effectiveness and safety of topical β-receptor blocker against other therapies. METHODS: A search of the literature using PubMed, Embase, Cochrane Review database, China National Knowledge Infrastructure and Wanfang were performed to identify the studies that estimated the effectiveness and safety of topical β-receptor blocker in treating SIH, the fixed-effect or random-effects meta-analytical techniques were applied to assess the outcomes. RESULTS: Twenty studies, involving 2098 patients, were included to conduct this analysis. Topical propranolol and topical timolol were discovered to be as effective as oral propranolol in treating SIH (propranolol, odds ratio [OR] = 0.486, 95% confidence interval [CI] 0.165, 1.426, P = .189; timolol, OR = 0.955; 95%CI 0.700, 1.302; P = .769), and topical timolol was more effective than topical imiquimod (OR = 2.561; 95%CI 1.182, 5.550; P = .017), observation (OR = 18.458; 95%CI 5.660, 60.191; P < .001) and topical saline solutions (OR = 19.193; 95%CI 8.837, 41.683; P < .001) in treating SIH. The comparison between topical propranolol and oral propranolol led to no discovery of significant difference in the incidence of adverse effects (OR = 1.258; 95%CI 0.471, 3.358; P = .647). Compared with oral propranolol, topical timolol was associated with fewer incidences of adverse effects (OR = 0.191; 95%CI 0.043, 0.858; P = .031). No significant difference in the incidence of adverse effects was found when topical timolol and topical imiquimod were compared (OR = 0.077; 95%CI 0.005, 1.206; P = .068). CONCLUSION: This meta-analysis provided evidence that topical β-receptor blockers (propranolol and timolol), especially timolol, may replace oral propranolol as a first-line treatment for SIH.
AIMS: To evaluate the effectiveness and safety of topical β-receptor blocker in treating superficial infantile haemangiomas (SIH) and compare the effectiveness and safety of topical β-receptor blocker against other therapies. METHODS: A search of the literature using PubMed, Embase, Cochrane Review database, China National Knowledge Infrastructure and Wanfang were performed to identify the studies that estimated the effectiveness and safety of topical β-receptor blocker in treating SIH, the fixed-effect or random-effects meta-analytical techniques were applied to assess the outcomes. RESULTS: Twenty studies, involving 2098 patients, were included to conduct this analysis. Topical propranolol and topical timolol were discovered to be as effective as oral propranolol in treating SIH (propranolol, odds ratio [OR] = 0.486, 95% confidence interval [CI] 0.165, 1.426, P = .189; timolol, OR = 0.955; 95%CI 0.700, 1.302; P = .769), and topical timolol was more effective than topical imiquimod (OR = 2.561; 95%CI 1.182, 5.550; P = .017), observation (OR = 18.458; 95%CI 5.660, 60.191; P < .001) and topical saline solutions (OR = 19.193; 95%CI 8.837, 41.683; P < .001) in treating SIH. The comparison between topical propranolol and oral propranolol led to no discovery of significant difference in the incidence of adverse effects (OR = 1.258; 95%CI 0.471, 3.358; P = .647). Compared with oral propranolol, topical timolol was associated with fewer incidences of adverse effects (OR = 0.191; 95%CI 0.043, 0.858; P = .031). No significant difference in the incidence of adverse effects was found when topical timolol and topical imiquimod were compared (OR = 0.077; 95%CI 0.005, 1.206; P = .068). CONCLUSION: This meta-analysis provided evidence that topical β-receptor blockers (propranolol and timolol), especially timolol, may replace oral propranolol as a first-line treatment for SIH.
Authors: Christine Léauté-Labrèze; Eric Dumas de la Roque; Thomas Hubiche; Franck Boralevi; Jean-Benoît Thambo; Alain Taïeb Journal: N Engl J Med Date: 2008-06-12 Impact factor: 91.245