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Efficacy and safety of adrenergic beta-antagonist combined with lasers in the treatment of infantile hemangiomas: a meta-analysis

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Abstract

To investigate the efficacy and safety of combined therapy with adrenergic beta-antagonist and lasers in infantile hemangiomas (IH). A search of Pubmed, Cochrane, Embase, Wanfang Date, CNKI (China National Knowledge Infrastructure) and CBM (China Biology Medicine) databases was conducted to identify studies that examined response to combined therapy with adrenergic beta-antagonist and laser in IH patients. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) in random-effects or fixed-effects models were calculated with Review Manger 5.3. Efficacy of combined therapy with oral propranolol and lasers was significantly better than that of propranolol (OR 5.79, 95% CI 2.52–13.31, P < 0.00001) or lasers (OR 5.09, 95% CI 3.04–8.54, P < 0.00001) alone. Combined therapy with topical timolol and lasers was more effective than topical timolol (OR 3.71, 95% CI 2.46–5.59, P < 0.00001) or lasers (OR 10.92, 95% CI 1.90–62.70, P = 0.007) alone. We did not observe statistically significant differences of adverse reactions between combined therapy with oral propranolol and lasers and propranolol (OR 1.09, 95% CI 0.64–1.84, P = 0.75) or lasers (OR 0.83, 95% CI 0.28–2.50, P = 0.74). The incidence of adverse reactions in combined therapy with topical timolol and lasers and monotherapy with topical timolol therapy (OR 0.50, 95% CI 0.14–1.80, P = 0.75) or lasers (OR 0.29, 95% CI 0.06–1.55, P = 0.15) has no significant difference. The average treatment duration of combined therapy may be shorter than that of monotherapy. Combination therapy of adrenergic beta-antagonist and lasers on IH is significantly more effective than monotherapy, while the safety of combination therapy was not significantly higher than that of monotherapy.

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Funding

This study was not funded by any organization or individual.

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Authors and Affiliations

  1. Department of Plastic Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, China

    Xingfan Chen, Yu Guo, Pu Wang, Fengzhen Qiu, Yuming Sun, Yuyan Deng, Chengjun Hu & Shaorong Lei

  2. Department of Breast and Thyroid Surgery, Liuzhou People’s Hospital, No. 8 Wenchang Road, Liuzhou City, Guangxi Zhuang Autonomous Region, China

    Qingmei Shi

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  1. Xingfan Chen
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  5. Yuming Sun
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  7. Yuyan Deng
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Contributions

XC designed the article outline and established the process, collected some data and conducted preliminary analysis and interpretation, wrote the article and was responsible for reviewing and revising the article. As the corresponding author of the article, SL conceptualized the article and explained the data, and critically revised important academic content. YG developed the data collection process and was responsible for part of the data analysis as the third independent evaluator, she also revised the article. PW and FQ were mainly responsible for searching the English databases and acted as two independent evaluators, screened and analyzed articles, and assisting in interpreting and analyzing the data. QS and YS were responsible for retrieving the Chinese database, assisting in the screening and analysis of articles, and contributed to the formulation and modification of forms and photo editing. YD and CH contributed to the data analysis and provided great help in describing the background knowledge of the article. All authors agreed with the final manuscript and approved submission for publication.

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Correspondence to Shaorong Lei.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was not required as this study was a retrospective meta-analysis article.

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Chen, X., Guo, Y., Wang, P. et al. Efficacy and safety of adrenergic beta-antagonist combined with lasers in the treatment of infantile hemangiomas: a meta-analysis. Pediatr Surg Int 36, 1135–1147 (2020). https://doi.org/10.1007/s00383-020-04711-2

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