Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis

Pediatrics
Sivakumar ChinnaduraiMelissa L McPheeters

Abstract

Infantile hemangiomas (IH) may be associated with significant functional impact. The objective of this study was to meta-analyze studies of pharmacologic interventions for children with IH. Data sources were Medline and other databases from 1982 to June 2015. Two reviewers assessed studies using predetermined inclusion criteria. One reviewer extracted data with review by a second. We included 18 studies in a network meta-analysis assessing relative expected rates of IH clearance associated with β-blockers and steroids. Oral propranolol had the largest mean estimate of expected clearance (95%; 95% Bayesian credible interval [BCI]: 88%-99%) relative to oral corticosteroids (43%, 95% BCI: 21%-66%) and control (6%, 95% BCI: 1%-11%). Strength of evidence (SOE) was high for propranolol's effects on reducing lesion size compared with observation/placebo. Corticosteroids demonstrated moderate effectiveness at reducing size/volume (moderate SOE for improvement in IH). SOE was low for effects of topical timolol versus placebo. Methodologic limitations of available evidence may compromise SOE. Validity of meta-analytic estimates relies on the assumption of exchangeability among studies, conditional on effects of the intervention. Results ...Continue Reading

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Citations

Oct 22, 2016·The Journal of Pathology·Sandra D CastilloNeil J Sebire
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