ORAL TOPICAL TIMOLOL MALEAT OR ORAL PROPRANOLOL TREATMENT FOR INFANTILE HEMANGIOMAS: CLINICAL ANALYSIS OF 403 PATIENTS

Ozlem Terzi, Esra Arslantas, Nur Cennet Bas, Gonca Ayse Kacar, Pasli Ezgi Uysalol, Avni Huseyin Solgun, Duygu Yildirgan, Ayse Ozkan Karagenc, Saide Erturk, Ali Aycicek

Abstract


Objective: Infantile hemangiomas (IH) are the most common benign vascular tumors of infancy. Propranolol (P), a nonselective beta-blocker, has been successfully used in managing IHs. Ongoing studies investigate the efficacy of the topical β-antagonist timolol maleate (TM) in IHs. The aim of this study is to assess the effects of interventions for managing infantile hemangiomas in children.

Material and Methods: We retrospectively reviewed a total of 403 IH patients from March 2021 to March 2022. The patients were stratified into three groups. Patients in Group 1 were given TM at a dose of one drop topically twice a day, 0.5%. Patients in Group 2 were given P at a dose of 1 mg/kg twice a day. The patients in Group 3 did not receive any treatment, and observation was conducted solely by contacting the controls.

Results: The median age of diagnosis was 5 months (range 0-60), with 57.1% of the cases being male. While TM treatment was applied to 32% of the children and P treatment was applied to 46.9% of the children, no treatment was administered in 21.1%. The most common location of hemangiomas was the face, accounting for 39.2%. Hemangiomas were observed in more than one location in 48 (12%) children. The median follow-up period for the patients was 4 months (range 0-28). Hemangiomas remained unchanged in 28.3% of all cases, shrank in 60.3%, and continued to grow in 11.4%. The primary indication for initiating TM was superficial hemangiomas and infants younger than 6 months. The leading reason for starting P significantly higher than in the other groups (p:0.001). No statistically significant differences were observed between the groups regarding bleeding and ulceration rates (p>0.05).

Conclusion: The efficacy of propranolol in treating IH was higher than that of TM.


Keywords


timolol maleate, infantile hemangioma, propranolol

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References


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