Diagnosis and Management of Infantile Hemangioma

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Table 11. Resolution outcomes in studies comparing beta-blockers and steroids (continued) Author, Year Comparison Groups (n) Quality Hoornweg et al. 2014 131 G1: Propranolol, oral 1- 3/mg/kg/day (14) G2: Intralesional triamcinolone acetonide and methylprednisolone (29) Quality: Fair Age, Months Type Age, median (IQR) G1: 2.66 (1.78) G2: 2.92 (2.53) Type, % Proliferation G1: 93 G2: 86 Involution G1: 7 G2: 14 Location G1+G2: periorbital Methods and Measures of Resolution/ Response Resolution Outcomes Rebound Growth/ Recurrence, n Other Outcomes, n (%) • NR NR Level of amblyopia 0 G1: 12 (86) G2: 11 (61) 1 G1: 1 (7) G2: 3 (17) 2 G1: 1 (7) G2: 0 3 G1: 0 G2: 1 (6) 4 G1: 0 G2: 2 (11) Need for additional therapies to reduce IH size G1: 1 (7) G2: 10 (34) G1 vs. G2: p=NS Duration of therapy, median months (IQR) G1: 6.5 (4.87) G2: 15.9 (10.3) G1 vs G2: p
Table 11. Resolution outcomes in studies comparing beta-blockers and steroids (continued) Author, Year Comparison Groups (n) Quality Malik et al. 2013 100 G1: Propranolol, oral 2- 3/mg/kg/day in two daily doses (10) G2: Prednisolone, oral 1-4 mg/kg/day (10) G3: Propranolol, oral 2- 3/mg/kg/day and Prednisolone, oral 1-4 mg/kg/day (10) Quality: Fair Rossler et al, 2012 132,133 G1: Oral propranolol, 2 mg/kg/day (30) G2: Oral prednisone, 2 mg/kg/day then reduced to 1 mg/kg/day (30) Quality: Poor Age, Months Type Age, mean G1: 4.6 G2: 5.5 G3: 4.7 Type, % Superficial G1+G2+G3: 53 Mixed G1+G2+G3: 26.7 Deep G1+G2+G3: 20 Age, mean G1: 4.4 G2: 2.8 Type: NR Location G1+G2+G 3: multiple G1+G2: multiple Methods and Measures of Resolution/ Response • Photographs assessed by 2 blinded assessors • Color and size based on Visual Analog Scale (VAS) • Improvement graded as: 75-100% 50-74% 25-49% 0-24% • Size measuring length and width • Blinded assessment: NR • IH score based on color, skin level, and turgor (scale 0-6) Resolution Outcomes Mean size reduction %, VAS G1: 89.8 G2: 66.6 G3: 82.6 Color fading, VAS G1: -9 G2: -8 G3: -9 Median size at end of therapy G1: 2.0 cm 2 G2: 3.5 cm 2 G1 vs G2: p=0.006 Median score G1: 2 G2: 3 G1 vs G2: p
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Comparative Effectiveness Review Nu
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This report is based on research co
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Acknowledgments The authors gratefu
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Peer Reviewers Prior to publication
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BCI; moderate SOE for effects of pr
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Overview of the Literature ........
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Executive Summary Introduction Infa
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for contextual questions as few eff
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Figure B. Analytic framework for KQ
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Table A. Inclusion criteria (contin
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precision (precise, imprecise), and
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Figure D. Estimates of expected IH
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majority of studies to date have in
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effectiveness outcomes. The evidenc
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changes. We considered the strength
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Table C. Summary of evidence in stu
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Table D. Summary of evidence in stu
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Applicability We set inclusion crit
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Page 45 and 46: References 1. Wassef M, Blei F, Ada
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Page 61 and 62: Results We present results for Cont
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Table 38. Strength of evidence for
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older children. One comparative stu
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case series reporting on rarer pres
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agents is critical, especially as u
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References 1. Wassef M, Blei F, Ada
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39. Chen TS, Eichenfield LF, Friedl
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80. Mai HM, Zheng JW, Wang YA, et a
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119. Sharma LK, Dalal SS. Corticost
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162. Snir M, Reich U, Siegel R, et
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198. Chen ZG, Zheng JW, Yuan ML, et
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237. Healy G, McGill T, Friedman EM
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Abbreviations and Acronyms Used in
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Appendix A. Search Strategies Searc
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Searches for Comparative Effectiven
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Appendix B. Screening and Quality A
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Harms Risk of Bias Assessment Form
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QUADAS Diagnostic Accuracy Rating T
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Infantile Hemangioma CER: Risk of B
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20. Grundfest-Broniatowski S, Carey
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65. Dachman AH, Lichtenstein JE, Fr
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111. Yoshida T, Kuratomi K, Mitsuma
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160. Newman SL, Goodwin CD. Colonic
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204. Crockett DM, Healy GB, McGill
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253. Wright GL, Smith RJ, Katz CD,
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301. Paley D, Jackson RW. Synovial
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346. Dombrowski MP, Budev H, Wolfe
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390. Stringel G. Giant hemangioma:
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436. Liu HC, Chang MH, Lue HC, et a
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480. Casale AJ, Menashe DS. Massive
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526. Taylor RS, Joseph DB, Kohaut E
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571. Goldstein MH. The elastic flap
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614. Salloum E, Flamant F, Caillaud
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880. Schulman SR, Jones BR, Slotnic
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924. Egawa H, Berquist W, Garcia-Ke
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968. Thompson DN, Taylor WF, Haywar
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1013. Gregg CM, Wiatrak BJ, Koopman
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1056. Rozylo TK, Krupski W, Galkows
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1099. Fremont S, Kanny G, Bieber S,
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1992. Woo SJ, Kim CJ, Yu YS. Cavern
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2036. Ersoy S, Mancini AJ. Hemifaci
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2117. Sabharwal GK, Strouse PJ. Pos
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2159. Cannady SB, Kahn TA, Trabouls
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2200. Karikari IO, Selznick LA, Cum
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2241. Pienaar C, Graham R, Geldenhu
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2283. Wananukul S, Voramethkul W, N
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2327. Czernik A, Bystryn JC. Does i
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2368. Kamida T, Takeda Y, Fujiki M,
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2410. Rodgers B, Zeim S, Crawford B
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2453. Zolkipli Z, Aylett S, Rankin
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2495. Egberts F, Mentzel T, Leuschn
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2537. Kutluhan A, Bozdemir K, Ugras
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2580. Saetti R, Silvestrini M, Cutr
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2869. Fernandez-Pineda I, Lopez-Gut
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2910. Kazim SF, Bhatti, Enam SA. In
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2953. Nonogaki S, Campos HGA, Butug
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2995. Storch CH, Hoeger PH. Propran
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3038. Al Dhaybi R, Superstein R, Mi
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3080. del Pozo J, Lopez-Gutierrez J
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3120. Guye E, Chollet-Rivier M, Sch
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3159. Kolokythas A, Al-Ghamian H, M
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3201. Nale P. Propranolol treatment
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3243. Soltani AM, Reinisch JF. Algo
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3286. . Derm Dx. Clinical Advisor.
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3326. Chang YT, Lin JY, Lee JY, et
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3367. Gross BC, Janus JR, Orvidas L
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3407. Kupeli S. Use of propranolol
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3448. Raches D, Hiscock M, Chapiesk
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3490. Traivaree C, Lumkul R, Torcha
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3532. Ammerman RT, Putnam FW, Altay
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3573. Chou S, Subramanian V, Lau HM
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3655. Masetti R, Colecchia A, Ronde
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3693. Parikh SR, Darrow DH, Grimmer
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3772. Zou HX, Jia J, Zhang WF, et a
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3969. Ravenscroft J. Management of
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where ΦΦ(xx) is the cumulative di
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Figure D-1. Estimates of expected I
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Figure D-3. Posterior SUCRA estimat
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Figure D-5. Network diagram of comp
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Appendix E. Study Design Classifica
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Author, Year Hogeling 2011 10 Alloc
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Author, Year Representativeness of
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Author, Year Were the harms predefi
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25. Qiu Y, Ma G, Yang J, et al. Imi
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56. Hassan BA, Shreef KS. Propranol
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88. Chakkittakandiyil A, Phillips R
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120. Pandey A, Gangopadhyay AN, Gop
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Appendix G. Applicability Tables Ta
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Appendix H. Harms Reported in Packa
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o Acquired (autoimmune) hemolytic a
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o Ankylosing spondylitis o Dermatom
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H-7 • Increased dosage of rapidly
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Elocon® (mometason e furoate) 11 T
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Timoptic® (timolol maleate) 15 Tim
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Harms Data for Medications Included
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Table H-3: Adverse Events from Flo-
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(
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thromboembolism, thrombophlebitis,
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grades): 103 (48%), erosion/ulcerat
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acute myocardial infarction: 3 (Rat
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Discontinuations Patients utilizing
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ocular irritation including blephar
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Diagnosis and Management of Infantile Hemangioma

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