COMPARISON OF OUTCOME OF OUTPATIENT TOPICAL TIMOLOL VS. ORAL PROPRANOLOL IN MANAGEMENT OF INFANTILE HEMANGIOMA: A SINGLE CENTER EXPERIENCE – A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: There is some debate about whether oral propranolol or topical timolol are more effective for treating infantile hemangioma, and only a few studies are available in the literature. The project aimed to compare efficacy and safety of topical timolol vs. oral propranolol in the management of superficial infantile hemangiomas in outpatients in terms of size reduction, color change and duration of treatment.

Materials & Methods: This randomized controlled trial was conducted at the Department of Pediatric Surgery, Lady Reading Hospital, Peshawar after IRB approval. Sixty patients with superficial infantile hemangioma were selected and were randomized into two groups, 30 in each group using the balloting method; Group-A (taking propranolol) and Group-B (taking topical timolol). The propranolol was split into two doses and taken within half an hour after each meal. Applying timolol maleate 0.5% hydro gel topically three times a day was the standard course of action. Visual analogue scale (VAS) scores, color shifts, and treatment duration were used to assess the success of the therapy. Cosmetic improvement was used to assign a value on the VAS (from -100 to 100). Therapy responses were ranked as outstanding (90– 100), good (51–90), fair (1–50), or poor (100–0). All the data were entered in SPSS 24 and analyzed.

Results: There was no significant difference for therapeutic response (Excellent therapeutic response: Propranolol: 42.5% vs. Topical Timolol: 45%, p-value=0.624) and adverse effects (p-value=0.112) in treatment groups.

Conclusion: Results of this study demonstrate that topical timolol and oral propranolol are equally effective for treating superficial infantile hemangiomas in terms of size reduction, color change, duration of treatment, efficacy and adverse effects.