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A New Alternative to Oral Propranolol for Infantile Hemangiomas :

August 17, 2016

The authors found that type of infant hemangioma, the duration of therapy and the initial thinness, and subtype of lesion influence whether this drug will work or not.

We and other journals have published quite a number of studies on hemangiomas, especially infantile hemangiomas and their responsiveness to oral propranolol. Recently a topical beta, blocker timolol maleate, has been considered as an off-label alternative to oral propranolol.  In a first of its kind study,  Puttgen et al. (peds.2016-0355) studied topical timolol.  The authors studied a multicenter retrospective cohort of more than 700 patients at 9 centers given timolol while their hemangiomas were followed weekly with photographs looking for improvement.

The authors found that type of infant hemangioma, the duration of therapy and the initial thinness, and subtype of lesion influence whether this drug will work or not.  While only 7% of patients required subsequent use of a beta blocker, the topical agent did show more benefits and only mild adverse events that were similar if not better than propranolol. So should you use this topical drug rather than oral propanol?  The authors speculate on that question in the discussion section of the paper given its benign and effective track record in this study? Share your thoughts on whether the data in this study are convincing enough to give topical timolol versus oral propranolol via a response to this blog, posting a comment with this article on our website or using our Twitter and Facebook sites.

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