Effectiveness and safety of polidocanol for the treatment of hemangiomas and vascular malformations: A meta-analysis

Dermatol Ther. 2018 Jan;31(1). doi: 10.1111/dth.12568. Epub 2017 Oct 30.

Abstract

A meta-analysis was conducted to investigate the efficacy and safety of polidocanol versus other conventional therapies in treating hemangiomas (HMs) and vascular malformations (VMs). Literature search was conducted in the Cochrane, Embase, PubMed, Web of Science, CNKI, CBM, VIP, and WanFang databases until March 5, 2017. A meta-analysis was conducted using Revman 5.3 software. A total of 19 randomized controlled trials (RCTs) involving 1,514 participants met the inclusion criteria. Regarding the effectiveness, statistically significant differences were observed between polidocanol and all the independent treatments (p = .006), but not between polidocanol and pingyangmycin (p = .16). Combination therapy of polidocanol with any other conventional treatments (p = .0001), pingyangmycin (p = .005) or hemoclip (p = .008) elicited a better response compared to treatment with these treatments independently. A meta-analysis on the risk of adverse events (AEs) showed a lower risk for polidocanol versus other treatments, for example, all the conventional treatments used independently (p < .00001) and pingyangmycin (p < .00001). Combination therapy of polidocanol with pingyangmycin also yielded a significantly lower risk of AEs (p < .00001). Polidocanol is at least as effective as other conventional therapies on HMs and VMs (especially venous malformations). The former is much safer. Combining its use with other treatments may produce excellent results. Our study provides strong evidence supporting the use of polidocanol for HMs and VMs.

Keywords: hemangiomas; polidocanol; vascular malformations.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibiotics, Antineoplastic / therapeutic use
  • Bleomycin / analogs & derivatives
  • Bleomycin / therapeutic use
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Hemangioma / pathology
  • Hemangioma / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Odds Ratio
  • Polidocanol
  • Polyethylene Glycols / administration & dosage*
  • Polyethylene Glycols / adverse effects
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Sclerosing Solutions / administration & dosage*
  • Sclerosing Solutions / adverse effects
  • Sclerotherapy / adverse effects
  • Sclerotherapy / methods*
  • Treatment Outcome
  • Vascular Malformations / diagnosis
  • Vascular Malformations / therapy*
  • Young Adult

Substances

  • Antibiotics, Antineoplastic
  • Sclerosing Solutions
  • Polidocanol
  • Bleomycin
  • Polyethylene Glycols
  • bleomycetin