title: Oral propranolol combined with topical timolol for compound infantile hemangiomas: a retrospective study.
abstract: Compound infantile hemangiomas (IHs) are problematic and usually require intervention. This retrospective study aimed to introduce a combined therapy of oral propranolol and topical timolol, and evaluate its efficacy and safety. Eighty-nine infants with compound IHs were treated with oral propranolol 2 mg/kg/day divided 2 times per day and timolol maleate 0.5% gel 3 times per day, for at least 3 months. Two observers evaluated the hemangioma independently at 0, 1, 3, 6, 9 months after the initiation of treatment. Changes in the hemangioma score values were evaluated using paired t test. Rebound growth and adverse effects were recorded. After treatment was completed, this combined therapy achieved clinical response in 100% of the patients (89/89). Significant positive effects were demonstrated at 1, 3, 6 months (p < 0.001), but not obvious after 6 months (p = 0.06). The response of IHs to the therapy was depending on the age at initial treatment. The average treatment duration was 6.48 (5.77-7.19) months. One patient (1.1%) relapsed after cessation of 6-month treatment, and 7 children (7.8%) developed side effects. Our study suggested that oral propranolol combined with topical timolol treatment is very effective and well-tolerated for compound IHs, which can be used as a first line treatment.
authors.affiliation: Department of Oromaxillofacial Head and Neck Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200000, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Ge
authors.affiliation: Department of Oromaxillofacial Head and Neck Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200000, China.
authors.forename: Jiawei
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Oromaxillofacial Head and Neck Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200000, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200000, China.
authors.forename: Weien
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200000, China.
authors.forename: Haiguang
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000359:Aftercare; D005260:Female; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D013999:Timolol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D013999:Timolol; D011433:Propranolol
references.citation: Eur J Pediatr. 2011 Apr;170(4):493-501
references.pmid: 20936416
references.citation: J Plast Reconstr Aesthet Surg. 2011 Apr;64(4):445-51
references.pmid: 20797926
references.citation: Pediatrics. 2011 Aug;128(2):e259-66
references.pmid: 21788220
references.citation: J Pediatr Surg. 2012 Apr;47(4):707-14
references.pmid: 22498385
references.citation: Ophthal Plast Reconstr Surg. 2012 Mar-Apr;28(2):103-6
references.pmid: 22410658
references.citation: Pediatr Dermatol. 2011 Nov-Dec;28(6):640-4
references.pmid: 21995836
references.citation: J Pediatr. 2012 Aug;161(2):240-5
references.pmid: 22497908
references.citation: Pediatrics. 2013 Jan;131(1):128-40
references.pmid: 23266923
references.citation: Pediatr Dermatol. 2013 Jan-Feb;30(1):160-1
references.pmid: 23316722
references.citation: Plast Reconstr Surg. 2013 Mar;131(3):601-13
references.pmid: 23142941
references.citation: Pediatr Dermatol. 2013 Mar-Apr;30(2):182-91
references.pmid: 23405852
references.citation: Br J Dermatol. 2013 Apr;168(4):837-43
references.pmid: 23278381
references.citation: Ulster Med J. 2013 Jan;82(1):16-20
references.pmid: 23620625
references.citation: J Pediatr Hematol Oncol. 2013 Oct;35(7):493-9
references.pmid: 23929318
references.citation: Pediatr Dermatol. 2012 Jan-Feb;29(1):127-30
references.pmid: 22256996
references.citation: Paediatr Perinat Epidemiol. 2012 Mar;26(2):156-62
references.pmid: 22324502
references.citation: Dermatol Surg. 2014 Apr;40(4):405-11
references.pmid: 24460784
references.citation: Acta Paediatr. 2014 Sep;103(9):977-83
references.pmid: 24837972
references.citation: J Plast Reconstr Aesthet Surg. 2014 Nov;67(11):1469-74
references.pmid: 25104131
references.citation: Ann Plast Surg. 2015 Feb;74(2):256-62
references.pmid: 25590249
references.citation: N Engl J Med. 2015 Feb 19;372(8):735-46
references.pmid: 25693013
references.citation: Pediatr Dermatol. 2008 Mar-Apr;25(2):168-73
references.pmid: 18429772
references.citation: Pediatrics. 2008 Aug;122(2):360-7
references.pmid: 18676554
references.citation: Dermatol Surg. 2009 Dec;35(12):1947-54
references.pmid: 19889007
references.citation: Br J Dermatol. 2010 Aug;163(2):269-74
references.pmid: 20456345
references.citation: Pediatr Dermatol. 2011 Mar-Apr;28(2):108-14
references.pmid: 21385205