Diagnosis and Management of Infantile Hemangioma

Figure D. Estimates of expected IH clearance
Note: Estimates of expected IH clearance are expressed as percent clearance relative to initial condition for each treatment, along
with associated posterior interquartile range (thick lines) and 95% credible interval (thin lines).
To assess for methodologic heterogeneity, we ran additional models with only RCTs and
with only good and fair quality studies. Estimates did not differ markedly when poor quality
studies were removed, though BCI typically widened; thus, we report the model with poor
quality studies included. To examine the possible effect of bias due to the inclusion of cohort
studies, we fit the same model to RCT studies only. The resulting estimates were similar to those
of the model fit to all studies, but with much wider posterior credible intervals. Since there was
no obvious systematic bias due to study design, we reported the model estimates based on the
entire body of evidence.
Corticosteroids
We identified 24 studies (three RCTs, one cohort study, and 20 case series) reporting
outcomes and/or harms following corticosteroid use in children with IH. Comparative studies
included a total of 239 children, and case series included 3508. We considered one RCT as good,
one as fair, and one as poor quality and the cohort study as fair quality. We rated all case series
as poor quality for harms reporting. Steroids studied varied in dose, type, and route of
administration, and the ages of children included in comparative studies ranged widely from 1 to
72 months. IH size was reduced significantly in the oral prednisolone arm compared with
intravenous methylprednisolone arm in one RCT.
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