Diagnosis and Management of Infantile Hemangioma

Table 37. Strength of evidence for harms of beta-blockers
Outcome
Study
Limitations
Study Design
Intervention
Consistency Directness Precision
Oral
propranolol
Quality and Number of
Studies (N Total)
Clinically important harms
(hypotension, bradycardia,
bronchospasm,
hypoglycemia)
Reporting
Bias
Finding
Strength of Evidence
Grade
High Consistent Direct Precise Undetected Rates of these harms with
oral propranolol ranged
from 0 to 100% across
studies.
RCT: 2 good, 1 poor 17,92,98
(515)
Cohort studies: 3 poor 94,97,147
(213)
Moderate SOE for
association of propranolol
with these harms based on
high study limitations.
Case series: 1 good, 15
poor 16,153,171,172,185,190,191,193-
195,199,200,202,203,205
(1249)
Minor harms (cold
extremities, diarrhea, sleep
changes)
RCT: 1 good, 3 poor 17,92,98,100
(545)
Cohort studies: 6
poor 94,96,131,132,145,147 (270)
High Consistent Direct Precise Undetected Rates of these harms with
propranolol ranged from
1% to 50% across studies.
Moderate SOE for
association of propranolol
with these harms given
relatively low numbers of
participants in studies.
Case series: 1 good, 12
poor 16,171,172,185,189-
191,193,195,200,202,203
(1140)
90