Safety and Efficacy of Imiquimod in the Treatment of Infantile Hemangioma; a Systematic Review and Meta-Analysis

Abdullah Alakeel

doi:10.15520/jcmro.v3i03.270

Abstract

Objective: To study the safety and efficacy of imiquimod in the treatment of infantile hemangioma (IH). Method: Systematic search was conducted in nine electronic databases for selecting relevant articles reporting the safety and efficacy of imiquimod as a therapeutic agent for treatment of IH. Meta-analysis was used to pool the results. Results: Of total 180 records screened, we included 9 studies for this systematic review and meta-analysis. About one-fifth of the patients (20.9%) have showed clinical resolution with 95% confidence interval (CI) of 11.8% to 34.1%. Regarding IH type, superficial type showed the highest rates of both clinical resolution and excellent response rates with 31.2% (95% CI= 16.6% to 50.8%) and 26.5% (95% CI= 11.6% to 49.6%), respectively. A relatively high prevalence of any side effects with 63.1% (95% CI= 47.6% to 76.3%) has been reported. The highest reported side effect was crustation (44.1%; 95% CI= 27.8% to 61.8%). Conclusion: Imiquimod is effective in the treatment of superficial IH and it is associated with local side effects.

Highlights

The two major types of vascular lesions in infants are; tumors and vascular malformations [1]
Regarding infantile hemangioma (IH) type, superficial type showed the highest rates of both clinical resolution and excellent response rates with 31.2% and 26.5%, respectively
Imiquimod is effective in the treatment of superficial IH and it is associated with local side effects

Summary

INTRODUCTION

The two major types of vascular lesions in infants are; tumors and vascular malformations [1]. Despite the fact that IHs are benign and self-limited in nature, they can cause serious complications such as ulceration or a permanent skin disfigurement [9, 12, 19]. They may compromise the functions of a vital organ or develop life-threatening visceral hemangiomas [9, 12, 19]. The approach to the treatment of hemangiomas should be individualized, based upon the size of the lesion, morphology, location, presence or possibility of complications, the potential for scarring or disfigurement, the age of the patient, and the rate of growth or involution at the time of evaluation [16, 20]. We aim to summarize the available evidence in this regard with stressing on the possible side effects as well

METHOD: Search strategy and study selection

RESULTS

DISCUSSION

Limitations

Findings

CONCLUSION