Abstract
Objective To assess the effectiveness and safety of propranolol in infantile hemangiomas by comparing with prednisone. Methods A systematic literature search of PubMed, Embase, Cochrane, Ovid, Google Scholar and CNKI, VIP, Wanfang database was conducted to identify studies about the treatment of propranolol in children with hemangiomas. We chose randomized controlled trials and clinical controlled trials. We selected literatures by certain standards. Results Eight papers including 9 studies were identified by the strategy mentioned above. These 8 literatures met our inclusion criteria after review by two independent reviewers. The studies comprised 407 patients. Six of the control group were oral prednisone, and there was no statistic heterogeneity (P=0.09, I2=0%). The fixed model was used to do the statistic analysis. The outcome showed the effective rate of propranolol was higher than that of prednisone, with statistically significant difference (OR=7.56, 95%CI: 3.18-17.98). Three of the control group included observation or oral placebo, without statistic heterogeneity (P=0.48, I2=0%) either. The outcome showed the effective rate of propranolol on hemangioma was higher than that of the control group (OR=23.15, 95%CI: 7.15-74.94). Of all the eight researches, five reported adverse effects, with statistic heterogeneity (P=0.0003, I2=81%). In addition, the adverse rate of propranolol was lower than that of prednisone, with statistically significant difference (OR=0.12, 95%CI: 0.02-0.75). Conclusions The results of this meta-analysis show that oral propranolol could obviously decrease the volume and improve the color of infantile hemangiomas. And propranolol is a significantly more effective for IH than steroids. The incidence of adverse effects of propranolol is also lower than that of prednisone. As a result, propranolol should be recommended as the first choice therapy for infantile hemangioma. Key words: Hemangioma; Propranolol; Meta-analysis
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