The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Research Institute of Plastic and Aesthetic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Dermatol Ther. 2022 Dec;35(12):e15907. doi: 10.1111/dth.15907. Epub 2022 Nov 9.
Topical timolol and lasers are widely used for the treatment of infantile hemangioma (IH), and they can replace propranolol as the first-line treatment of IH. We aimed to investigate the efficacy and safety of topical timolol alone or lasers plus topical timolol versus lasers alone for the treatment of IH using a meta-analysis. We searched the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases. A more conservative random effect model meta-analysis technique was used to analyze the efficacy and adverse reactions of timolol and lasers. Ten RCTs with a total of 979 patients with IH were included in this meta-analysis. Treatment with topical timolol alone was as effective as lasers in treating IH (risk ratio [RR] = 0.99, p = 0.94), with similar adverse events. The difference was not statistically significant (RR = 1.67, p = 0.14). Combined treatment with topical timolol and lasers showed a favorable response rate compared with treatment with either lasers (RR = 1.23, p = 0.01) or topical timolol (RR = 1.35, p = 0.001) alone. Furthermore, compared to topical timolol alone, the combined treatment indicated similar risks of adverse events (RR = 0.70, p = 0.38) but fewer risks of adverse events (RR = 0.39, p = 0.004) compared to lasers alone. This meta-analysis provided evidences that a combined treatment with topical timolol and lasers might be more effective than a single treatment strategy in infants with IH, and with no significant increase in adverse reactions. The combination of topical timolol and laser therapy might be the preferred choice for the treatment of IHs.
局部使用噻吗洛尔和激光广泛用于治疗婴幼儿血管瘤（IH），可替代普萘洛尔作为 IH 的一线治疗药物。本研究旨在通过荟萃分析探讨单独使用噻吗洛尔或激光联合局部使用噻吗洛尔与单独使用激光治疗 IH 的疗效和安全性。我们检索了 PubMed、Embase、Cochrane 图书馆、中国知网和万方数据库。使用更保守的随机效应模型荟萃分析技术来分析噻吗洛尔和激光的疗效和不良反应。本荟萃分析纳入了 10 项 RCT 研究，共 979 例 IH 患者。单独使用噻吗洛尔治疗 IH 的疗效与激光治疗相当（风险比 [RR] = 0.99，p = 0.94），且不良反应相似。差异无统计学意义（RR = 1.67，p = 0.14）。噻吗洛尔联合激光治疗的有效率高于激光（RR = 1.23，p = 0.01）或单独使用噻吗洛尔（RR = 1.35，p = 0.001）。此外，与单独使用噻吗洛尔相比，联合治疗与单独使用激光治疗的不良反应风险相似（RR = 0.70，p = 0.38），但不良反应风险较低（RR = 0.39，p = 0.004）。本荟萃分析表明，与单一治疗策略相比，噻吗洛尔联合激光治疗可能对 IH 患儿更有效，且不良反应无明显增加。噻吗洛尔联合激光治疗可能是 IH 治疗的首选方案。
