Topical Timolol Maleate Treatment of Infantile Hemangiomas
- 1 September 2016
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 138 (3), e20160355
- https://doi.org/10.1542/peds.2016-0355
Abstract
BACKGROUND: There has been a dramatic increase in the off-label use of ophthalmic timolol maleate, a β-blocker used for infantile hemangioma (IH) treatment as a topical counterpart to oral propranolol. Its safety and efficacy in a pediatric population with IH have not been evaluated in a large cohort. Our goal was to retrospectively assess timolol’s effectiveness, discern characteristics associated with response, and document reported adverse events. METHODS: A multicenter retrospective cohort study of 731 patients treated with topical timolol was completed at 9 centers. Inclusion required an IH suitable for timolol in the treating physician’s judgment and access to clinical details including photographs. Logistic regression analysis and descriptive statistics were performed. Primary outcome measures were efficacy assessed by using visual analog scales for color and for size, extent, and volume from review of digital photographs taken as standard of care. RESULTS: Most IHs were localized (80.1%) and superficial (55.3%). Risk of disfigurement was the most common indication for therapy (74.3%). Duration of therapy (P < .0001), initial thinness (P = .008), and subtype (P = .031) were significant predictors of response. Best response occurred in superficial IHs CONCLUSIONS: Timolol seems to be a well-tolerated, safe treatment option with moderate to good effectiveness, demonstrating best response in thin, superficial IHs regardless of pretreatment size. Timolol can be recommended as an alternative to systemic β-blockers and watchful waiting for many patients.Keywords
This publication has 32 references indexed in Scilit:
- Topical Timolol 0.5% Gel‐Forming Solution for Small Deep Facial Infantile HemangiomasPediatric Dermatology, 2013
- RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-OldsPublished by American Academy of Pediatrics (AAP) ,2013
- A Controlled Study of Topical 0.25% Timolol Maleate Gel for the Treatment of Cutaneous Infantile Capillary HemangiomasOphthalmic Plastic & Reconstructive Surgery, 2012
- Topical Timolol for Infantile Hemangiomas: Putting a Note of Caution in “Cautiously Optimistic”Pediatric Dermatology, 2012
- Timolol Maleate 0.5% or 0.1% Gel‐Forming Solution for Infantile Hemangiomas: A Retrospective, Multicenter, Cohort StudyPediatric Dermatology, 2011
- Untreated Hemangiomas: Growth Pattern and Residual LesionsPlastic and Reconstructive Surgery, 2011
- Betaxolol hydrochloride ophthalmic suspension 0.25% and timolol gel-forming solution 0.25% and 0.5% in pediatric glaucoma: A randomized clinical trialJournal of American Association for Pediatric Ophthalmology and Strabismus, 2009
- Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics supportJournal of Biomedical Informatics, 2008
- Propranolol for Severe Hemangiomas of InfancyNew England Journal of Medicine, 2008
- Ophthalmic timolol: Plasma concentration and systemic cardiopulmonary effectsScandinavian Journal of Clinical and Laboratory Investigation, 2007