Diagnosis and Management of Infantile Hemangioma

Table 36. Strength of evidence for effectiveness of beta-blockers (continued)
Outcome
Intervention
Topical timolol vs.
timolol+PDL
Topical timolol vs.
PDL + Nd:YAG
laser
Study Design
Quality and
Number of
Studies (N Total)
Improvement in IH
Cohort studies: 1
poor 106 (102)
Improvement in IH
RCT: 1 fair 14 (60)
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
High Unknown Direct Imprecise NA Timolol+PDL more effective than
timolol alone (p=0.02).
Insufficient SOE due to single study
with high limitations.
High Unknown Direct Imprecise Undetected Greater response to timolol among
superficial IH and greater response
to laser among mixed IH (p=NR).
Topical timolol vs.
Topical Imiquimod
Improvement in IH
Cohort studies: 1
fair 105 (38)
Insufficient SOE due to single study
with high limitations.
High Unknown Direct Imprecise NA No significant differences in
improvement in IH between groups.
Insufficient SOE due to single study
with high limitations.
BCI = bayesian credible interval; IH = infantile hemangioma; N = number; Nd:YAG = neodymium yttrium aluminum garnet ; PDL = pulsed dye laser; RCT = randomized
controlled trial; SOE = strength of evidence
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