Clinical Evaluation of Efficacy and Safety of Combined Topical Timolol and Oral Propranolol in Children with Infantile Hemangioma

Year 2018, , 1 - 8, 10.03.2018

Abdulameer Abdulbari Abdulhameed Kalil Esmail Al-hamdi Muntaha Abdulhadi Mathkoor

https://doi.org/10.5799/jcei.413049

Abstract

Objective:
To evaluate the
efficacy and safety of combined topical timolol and oral propranolol in
treatment of infantile hemangioma.

Patients
and methods: This
prospective study was conducted in Basra teaching hospital in Basra, Iraq,
where a total of 23 infants with 34 lesions of different types of hemangioma
were included. All lesions were in proliferation phase. The infants’ ages were
less than one year. They were treated with topical timolol solution 0.5%
combined with oral propranolol in a period of 12 weeks (8-16 weeks). The
response to treatment was evaluated clinically by using hemangioma score and
Visual analogue scale. All infants followed 4-12 months after cessation of
drugs.

Results:
By using
hemangioma score system; the combined therapy showed that, 28 (82.4%) lesions
showed excellent response, two (5.9%) showed good response, four (11.8%) showed
fair response and none of the lesions showed poor response at end of 16 weeks.
At the end of 4 months superficial hemangioma showed 100% reduction in their
score, while the ulcerative hemangioma showed 94.7% reduction in their score
while mixed hemangioma showed only 76.7% reduction in their scores. Complete
resolution occurred in 50% of lesions after 4 months of treatment. Neither
included infants developed serious side effects nor, any of the regressed
hemangioma recur during the follow up.

Conclusion:
Combined
topical Timolol 0.5% solution and oral propranolol seems to be a
well-tolerated, safe treatment option with a good to excellent responses. The
most responsive type of hemangioma to this combination are the superficial and
ulcerative types. 

Keywords

Hemangioma, children, treatment, timolol, propranolol, outcome

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