Diagnosis and Management of Infantile Hemangioma

Table 19. Key resolution outcomes in studies comparing timolol and observation or placebo
(continued)
Author,
Year
Comparison
Groups (n)
Quality
Chambers et
al. 2012 144
G1: Timolol
maleate gel
0.25% (13)
G2:
Observation
(10)
Quality: Fair
Yu et al.
2013 103
G1: Timolol ,
topical,
drops three
times
daily(101)
G2:
Observation
(23)
Age, Months
Type
Age,
mean±SD
G1: 4.8
G2: 3.7
Type, n
Superficial
G1: 5
G2: 4
Mixed
G1: 7
G2: 5
Deep
G1: 1
G2: 1
Age
1-6 months
G1+G2: 88
7-12 months
G1 +G2: 36
Type, %
Superficial:
100
Location
Periocular
(100%)
G1+G2:
multiple
Methods and
Measures of
Resolution/
Response
• Photographs
• Response
categorized as
good (lesion
decreased by
more than 50%
size), moderate
(lesion
decreased by
50% or less)
and poor (lesion
enlarged or
caused ptosis or
induced
astigmatism
• Reviewed by
blinded pediatric
ophthalmologist
• Photographs
• Categorized as:
Class 1:
ineffective
Class 2:
controlled
growth
Class 3:
promoted
regression
• Blinded
assessment: NR
Resolution
Outcomes
Response to
treatment, n (%)
Good
G1: 8 (61)
G2: 0
Moderate
G1: 4 (31)
G2: 1 (10)
Poor
G1: 1 (8)
G2: 9 (90)
G1 vs.G2 p=0.001
Response to
treatment, n (%)
Class 1
G1: 8 (7.9)
G2: 15 (65.2)
Class 2
G1: 36 (35.6)
G2: 7 (30.4)
Class 3
Quality:
G1: 57 (56.4)
Poor
G2: 1 (4.3)
G = group; IH = infantile hemangioma; n = number; NR = not reported; SD = standard deviation
Rebound
Growth/
Recurrence, n
(%)
NR
In 12 patients
with complete
resolution, no
regrowth noted
at 3-5 month
followup
Timolol Ophthalmic Solution Versus Imiquimod Cream
One fair quality retrospective cohort study evaluated imiquimod cream versus timolol
ophthalmic solution for treatment of superficial proliferating IH (Table 20). 105 There were 40
treated IH among the participants. The mean duration of therapy was 4.6 months in the
imiquimod group and 4.3 months in the timolol group. Duration of followup was not reported.
The VAS score and change in the hemangioma activity score did not differ significantly between
the two groups.
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