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Review
. 2014 Jul;78(1):44-57.
doi: 10.1111/bcp.12235.

The effectiveness of propranolol in treating infantile haemangiomas: a meta-analysis including 35 studies

Yin Lou  1 , Wen-jia Peng, Yi Cao, Dong-sheng Cao, Juan Xie, Hong-hong Li
Affiliations
Review

The effectiveness of propranolol in treating infantile haemangiomas: a meta-analysis including 35 studies

Yin Lou et al. Br J Clin Pharmacol. 2014 Jul.

Abstract

Aims: Propranolol may have shown excellent results as a first line therapy in infantile haemangiomas (IHs) at all sites in the body, but this conclusion remains controversial. In an attempt to resolve this issue, we performed a meta-analysis.

Methods: A search of the literature using PubMed, MEDLINE, Cochrane Library databases and China National Knowledge Infrastructure (CNKI) was performed to identify studies which estimated the efficacy of propranolol therapy in infants with haemangiomas all sites of the body. The pooled odds ratio (OR) along with the corresponding 95% confidence intervals (CI) were assessed using a fixed effects model.

Results: Thirty-five studies involving 324 infantile haemangioma(IH) patients and 248 controls were retrieved and analyzed. The efficacy of propranolol was greater than other therapies in treating IHs (OR = 9.67, 95% CI 6.62, 14.12, P < 0.001). In a stratified analysis by sites of tumour, propranolol was a more effective therapy when compared with steroids (OR = 9.67, 95% CI 6.61, 14.15, P < 0.001), vincristine (OR = 9.00, 95% CI 2.15, 37.66, P = 0.003) and laser treatment (OR = 9.00, 95% CI 1.42, 57.12, P = 0.020) in treating cutaneous IHs (OR = 24.95, 95% CI 9.48, 65.64, P < 0.001), peri-ocular IHs (OR = 9.39, 95% CI 3.88, 22.71, P < 0.001), infantile airway haemangiomas (OR = 20.91, 95% CI 7.81, 55.96, P < 0.001) and infantile hepatic haemangiomas (OR = 9.89, 95% CI 1.20, 81.54, P = 0.033).

Conclusion: The current meta-analysis provided strong evidence for propranolol as a first line therapy for IHs.

Keywords: effectiveness; infantile haemangiomas; meta-analysis; propranolol.

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Figures

Figure 1
Figure 1
Flow diagram of the selection process for the articles
Figure 2
Figure 2
Forest plot of the effectiveness of propranolol compared with other treatments in treating IHs
Figure 3
Figure 3
Forest plot of the effectiveness of propranolol compared with steroids in treating IHs
Figure 4
Figure 4
Forest plot of the effectiveness of propranolol compared with vincristine in treating IHs
Figure 5
Figure 5
Forest plot of the effectiveness of propranolol compared with laser in treating IHs
Figure 6
Figure 6
Forest plot of the effectiveness of propranolol compared with other treatments in treating cutaneous IHs
Figure 7
Figure 7
Forest plot of the effectiveness of propranolol compared with other treatments in treating peri-ocular IHs
Figure 8
Figure 8
Forest plot of the effectiveness of propranolol compared with other treatments in treating infantile airway haemangiomas
Figure 9
Figure 9
Forest plot of the effectiveness of propranolol compared with other treatments in treating infantile hepatic haemangiomas
Figure 10
Figure 10
Forest plot of the effectiveness of propranolol compared with steroids in treating IHs in RCT subgroup analysis by good degree
Figure 11
Figure 11
Forest plot of the effectiveness of propranolol compared with steroids in treating IHs in RCT subgroup analysis by excellent degree
See this image and copyright information in PMC

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