Good Clinical Responders to Topical Timolol in Patients with Infantile Hemangiomas: A 7-Year Retrospective Study of 328 Korean Patients
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초록
Background: Topical timolol is widely used for treatment of superficial infantile hemangioma(IH). However, little is known about factors that affect the response to topical timololtreatment. Objective: This study aimed to investigate the efficacy, safety, and predictive value for goodresponse to topical timolol for IH. Methods: A retrospective review of medical records and clinical photos of 328 patientswith IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographswere compared with those at the initial visit using a 100-mm visual analogue scale(VAS). Treatment response was defined as an improvement of at least 75% from baselinein IH lesions within 12 months of treatment. Results: Overall, IH patients treated with topical timolol showed significant improvementfrom baseline, showing that the final VAS score within 12 months of treatment was69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment(p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexuralarea (p=0.007) were significantly associated with treatment response. Only four patients(1.1%) reported local irritation. Conclusion: This study demonstrated that topical timolol treatment was an effective andwell-tolerated treatment for IHs. Physicians are encouraged to consider several patient- orlesional factors that might affect treatment response to achieve better clinical outcomes.
Abstract
Background: Topical timolol is widely used for treatment of superficial infantile hemangioma(IH). However, little is known about factors that affect the response to topical timololtreatment. Objective: This study aimed to investigate the efficacy, safety, and predictive value for goodresponse to topical timolol for IH. Methods: A retrospective review of medical records and clinical photos of 328 patientswith IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographswere compared with those at the initial visit using a 100-mm visual analogue scale(VAS). Treatment response was defined as an improvement of at least 75% from baselinein IH lesions within 12 months of treatment. Results: Overall, IH patients treated with topical timolol showed significant improvementfrom baseline, showing that the final VAS score within 12 months of treatment was69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment(p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexuralarea (p=0.007) were significantly associated with treatment response. Only four patients(1.1%) reported local irritation. Conclusion: This study demonstrated that topical timolol treatment was an effective andwell-tolerated treatment for IHs. Physicians are encouraged to consider several patient- orlesional factors that might affect treatment response to achieve better clinical outcomes.
참고문헌 (38)
- Kilcline C, "Infantile hemangiomas: how common are they? A systematic review of the medical literature", Pediatr Dermatol, 25, pp.168~173 (2008)
- Munden A, "Prospective study of infantile haemangiomas : incidence, clinical characteristics and association with placental anomalies", Br J Dermatol, 170, pp.907~913 (2014)
- Léauté-Labrèze C, "Infantile haemangioma", Lancet, 390, pp.85~94 (2017)
- Léauté-Labrèze C, "Propranolol for severe hemangiomas of infancy", N Engl J Med, 358, pp.2649~2651 (2008)
- Leung AKC, "Infantile hemangioma : an updated review", Curr Pediatr Rev, 17, pp.55~69 (2021)
- Wedgeworth E, "Propranolol in the treatment of infantile haemangiomas : lessons from the European Propranolol In the Treatment of Complicated Haemangiomas(PITCH)Taskforce survey", Br J Dermatol, 174, pp.594~601 (2016)
- Léauté-Labrèze C, "A randomized, controlled trial of oral propranolol in infantile hemangioma", N Engl J Med, 372, pp.735~746 (2015)
- Marqueling AL, "Propranolol and infantile hemangiomas four years later : a systematic review", Pediatr Dermatol, 30, pp.182~191 (2013)
- Moyakine AV, "Propranolol treatment of infantile hemangioma(IH)is not associated with developmental risk or growth impairment at age 4years", J Am Acad Dermatol, 75, pp.59~63 (2016)
- 이현지, "유아혈관종 환아 375명에서 두 가지 제형의 경구 프로프라놀롤 치료 효과와 안전성에 대한 한국 단일기관에서의 경험", 대한피부과학회지, 59(3), pp.196~205 (2021), 대한피부과학회
- Langley A, "Propranolol and central nervous system function : potential implications for paediatric patients with infantile haemangiomas", Br J Dermatol, 172, pp.13~23 (2015)
- Martin K, "Propranolol treatment of infantile hemangiomas : anticipatory guidance for parents and caretakers", Pediatr Dermatol, 30, pp.155~159 (2013)
- 오재홍, "신생아 집중치료실 환아에서 유아혈관종의 위험인자 분석", 대한피부과학회지, 59(5), pp.332~340 (2021), 대한피부과학회
- Danarti R, "Topical timolol maleate 0. 5% for infantile hemangioma : its effectiveness compared to ultrapotent topical corticosteroids-a single-center experience of 278 cases", Dermatology, 232, pp.566~571 (2016)
- 박영운, "Timolol 국소 도포로 치료한 궤양성 영아 혈관종", 대한피부과학회지, 50(10), pp.880~883 (2012), 대한피부과학회
- Xu DP, "Topical timolol maleate for superficial infantile hemangiomas : an observational study", J Oral Maxillofac Surg, 73, pp.1089~1094 (2015)
- Chan H, "RCT of timolol maleate gel for superficial infantile hemangiomas in 5-to 24-week-olds", Pediatrics, 131, pp.e1739~ (2013)
- Khan M, "The role of topical timolol in the treatment of infantile hemangiomas : a systematic review and meta-analysis", Acta Derm Venereol, 97, pp.1167~1171 (2017)
- Zheng L, "Effect of topical timolol on response rate and adverse events in infantile hemangioma : a meta-analysis", Arch Dermatol Res, 310, pp.261~269 (2018)
- Wang X, "The efficacy and safety of topical β-blockers in treating infantile hemangiomas : a metaanalysis including 11 randomized controlled trials", Dermatology, 237, pp.433~443 (2021)
- Qiao J, "Efficacy of combined topical timolol and oral propranolol for treating infantile hemangioma : a meta-analysis of randomized controlled trials", Front Pharmacol, 11, pp.554847~ (2020)
- He L, "Spectral Doppler ultrasound for predicting longterm response to topical timolol in children with infantile hemangioma", J Clin Ultrasound, 45, pp.480~487 (2017)
- Wu HW, "Topical application of 0. 5% timolol maleate hydrogel for the treatment of superficial infantile hemangioma", Front Oncol, 7, pp.137~ (2017)
- Wu HW, "Topical timolol vs. oral propranolol for the treatment of superficial infantile hemangiomas", Front Oncol, 8, pp.605~ (2018)
- Muñoz-Garza FZ, "Efficacy and safety of topical timolol for the treatment of infantile hemangioma in the early proliferative stage : a randomized clinical trial", JAMA Dermatol, 157, pp.583~587 (2021)
- Chansky PB, "Cutaneous dermatomyositis disease course followed over time using the Cutaneous Dermatomyositis Disease Area and Severity Index", J Am Acad Dermatol, 79, pp.464~469 (2018)
- 김병욱, "A Randomized, Evaluator-Blinded, Split-Face Comparison Study of the Efficacy and Safety of a Novel Mannitol Containing Monophasic Hyaluronic Acid Dermal Filler for the Treatment of Moderate to Severe Nasolabial Folds", Annals of Dermatology, 28(3), pp.297~303 (2016), 대한피부과학회
- Wang Y, "Mental health status of cisgender and gender-diverse secondary school students in China", JAMA Netw Open, 3, pp.e2022796~ (2020)
- Vossen ARJV, "Apremilast for moderate hidradenitis suppurativa : results of a randomized controlled trial", J Am Acad Dermatol, 80, pp.80~88 (2019)
- van Gils RF, "The effectiveness of integrated care for patients with hand eczema : results of a randomized, controlled trial", Contact Dermatitis, 66, pp.197~204 (2012)
- 김도엽, "Factors Determining Treatment Response to Cryotherapy for Foot Warts", Annals of Dermatology, 31(4), pp.457~460 (2019), 대한피부과학회[DOI]
- Park YW, "Effect of propranolol on the treatment of infantile hemangiomas : a single tertiary center 3-year experience", J Dermatolog Treat, 25, pp.391~395 (2014)
- Drolet BA, "Infantile hemangiomas : an emerging health issue linked to an increased rate of low birth weight infants", J Pediatr, 153, pp.712~715 (2008)
- Ding Y, "Risk factors for infantile hemangioma : a meta-analysis", World J Pediatr, 16, pp.377~384 (2020)
- Nedelec B, "Skin characteristics : normative data for elasticity, erythema, melanin, and thickness at 16 different anatomical locations", Skin Res Technol, 22, pp.263~275 (2016)
- Püttgen K, "Topical timolol maleate treatment of infantile hemangiomas", Pediatrics, 138, pp.e20160355~ (2016)
- Weibel L, "Topical timolol for infantile hemangiomas : evidence for efficacy and degree of systemic absorption", Pediatr Dermatol, 33, pp.184~190 (2016)
- Borok J, "Safety and efficacy of topical timolol treatment of infantile haemangioma : a prospective trial", Br J Dermatol, 178, pp.51~52 (2018)
