Huang Xiaoye, Si Wenyue, Zou Zhili, Li Binyao, Mu Yide, Zhong Wei, Yang Kaiying
Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, National Children's Medical Center for South Central Region, Guangzhou Medical University, Guangzhou, China.
School of Pediatrics, Guangzhou Medical University, Guangzhou, China.
Front Pharmacol. 2024 Dec 2;15:1515901. doi: 10.3389/fphar.2024.1515901. eCollection 2024.
Propranolol, a nonselective β-blocker, is the first-line treatment for infantile hemangioma (IH). Topical timolol has recently been proposed as a novel IH treatment with fewer adverse effects. This study was conducted to compare the efficacy and safety of oral propranolol and topical timolol for treating IH.
Studies were included after searching PubMed, Embase, Web of Science, and the Cochrane Library via the keywords of "propranolol", "timolol", "infantile hemangioma" and their synonyms. A meta-analysis with pooled odds ratios was performed using the fixed-effect model.
Seven articles with 2071 patients were included in this meta-analysis. Compared with topical timolol, oral propranolol had a greater response rate (OR = 2.12, < 0.001), but it was also associated with a greater risk of adverse events (OR = 2.31, < 0.001). For superficial IH, timolol demonstrated similar efficacy to propranolol (OR = 1.28, = 0.34) but with fewer adverse events (OR = 2.30, = 0.001). Additionally, compared with topical timolol, propranolol at a dosage of 2 mg/kg/d had a better response rate (OR = 2.62, < 0.001), whereas the 1.0∼1.5 mg/kg/d propranolol group showed no significant difference (OR = 1.34, = 0.38).
Oral propranolol presents superior therapeutic efficacy in the treatment of IH compared to topical timolol. However, topical timolol can serve as an alternative to oral propranolol for treating superficial IH, providing similar efficacy with fewer adverse effects. Additionally, propranolol at a dosage of 2 mg/kg/d offers greater efficacy with a comparable safety profile, whereas the 1.0∼1.5 mg/kg/d propranolol dosage shows no significant difference in efficacy compared to timolol but is associated with more adverse events.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024603724, identifier CRD42024603724.
普萘洛尔，一种非选择性β受体阻滞剂，是婴儿血管瘤（IH）的一线治疗药物。局部用噻吗洛尔最近被提议作为一种不良反应较少的新型IH治疗方法。本研究旨在比较口服普萘洛尔和局部用噻吗洛尔治疗IH的疗效和安全性。
通过检索PubMed、Embase、Web of Science和Cochrane图书馆，使用关键词“普萘洛尔”、“噻吗洛尔”、“婴儿血管瘤”及其同义词来纳入研究。采用固定效应模型进行合并比值比的Meta分析。
本Meta分析纳入了7篇文章，共2071例患者。与局部用噻吗洛尔相比，口服普萘洛尔有更高的有效率（OR = 2.12，P < 0.001），但也有更高的不良事件风险（OR = 2.31，P < 0.001）。对于浅表性IH，噻吗洛尔显示出与普萘洛尔相似的疗效（OR = 1.28，P = 0.34），但不良事件较少（OR = 2.30，P = 0.001）。此外，与局部用噻吗洛尔相比，2mg/kg/d剂量的普萘洛尔有更好的有效率（OR = 2.62，P < 0.001），而1.0～1.5mg/kg/d普萘洛尔组无显著差异（OR = 1.34，P = 0.38）。
与局部用噻吗洛尔相比，口服普萘洛尔在治疗IH方面具有更好的治疗效果。然而，局部用噻吗洛尔可作为口服普萘洛尔治疗浅表性IH的替代药物，疗效相似但不良反应较少。此外，2mg/kg/d剂量的普萘洛尔疗效更佳且安全性相当，而1.0～1.5mg/kg/d剂量的普萘洛尔与噻吗洛尔相比疗效无显著差异，但不良事件更多。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024603724，标识符CRD42024603724。
