Background: Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis.
Methods: We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability.
Findings: A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction.
Interpretation: A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred.
Funding: No funding was received.
Keywords: ATL, atenolol; CAP, captopril; CI, confidence intervals; H, a higher dose; Hemangioma; IH, infantile hemangioma; IMQ, imiquimod; L, a longer treatment duration; LPDL, PDL at a long pulse duration; Laser, PDL and Nd:YAG laser; NMA, network meta-analysis; Nd, Nd:YAG laser; Network meta-analysis; OR, odds ratios; PDL, pulsed dye laser; PED, prednisone; PRO, propranolol; RCT, randomized clinical trials; S, a shorter treatment duration; SUCRA, surface under the cumulative ranking curve; TA, triamcinolone; Therapeutics; β, topical β-blockers treatment.
© 2020 The Authors.