Diagnosis and Management of Infantile Hemangioma

Table 35. Strength of evidence for effectiveness and harms of steroids
Outcome
Intevention
Oral steroids
vs. Observation
or Placebo
Intralesional
steroids vs.
Observation or
Placebo
Study Design
Quality and
Number of Studies
(N Total)
Improvement in IH
Network metaanalysis
Improvement in IH
Network metaanalysis
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
High Consistent Indirect Imprecise Undetected In network meta-analysis oral steroids
had a mean expected clearance rate
of 43% (95% BCI: 21% to 66%)
compared with 6% (95% BCI: 1% to
11%) for placebo/observation arms.
Moderate SOE for greater
effectiveness of oral steroids vs.
placebo/observation given low
precision and high study limitations.
High Consistent Indirect Imprecise Undetected In network meta-analysis intralesional
steroids had a mean expected
clearance rate of 58% (95% BCI: 22%
to 99%) compared with 6% (95% BCI:
1% to 11%) for placebo/observation
arms.
Low SOE for greater effectiveness of
intralesional steroids vs.
placebo/observation given relatively
small numbers of participants
contributing to this comparison and low
precision.
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