Efficacy and adverse effects of oral propranolol in infantile hemangioma: a meta-analysis of comparative studies

医学 荟萃分析 相对风险 不利影响 子群分析 科克伦图书馆 出版偏见 置信区间 普萘洛尔 内科学 严格标准化平均差 随机对照试验
作者
Hao Yang,Donglai Hu,Qiang Shu,Xiaodong Guo
出处
期刊:World Journal of Pediatrics [Springer Science+Business Media]
卷期号:15 (6): 546-558 被引量:47
标识
DOI:10.1007/s12519-019-00285-9
摘要

A number of clinical trials evaluated the efficacy and adverse effects of oral propranolol in the treatment of infantile hemangioma (IH), but the treatment has not yet been standardized. This meta-analysis aims to reevaluate the efficacy and adverse effects of oral propranolol in comparative studies and to provide a reliable basis for clinical administration in the therapy for IH.Data were obtained from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang database, from inception to December 1st, 2018. The pooled risk ratios (RR) with 95% confidence intervals (95% CI) were calculated and used to evaluate the effect size. The meta-analysis was performed using the random-effects model due to heterogeneity between the studies. The Cochrane Collaboration 6 aspects of bias, methodological index for non-randomized studies and the Newcastle-Ottawa Scale were used to assess the risk for bias. Sensitivity analysis, publication bias and subgroup analysis were performed.Eighteen unique studies involving 2701 unique children were included in the analysis. The response rate was reported in 18 trials, which compared oral propranolol with other treatments. The heterogeneity was statistically significant (P < 0.00001, I2 = 95%). The difference in the response rate was statistically significant (RR = 1.40, 95% CI 1.13-1.75) while compared with the controls. However, no significant difference in the adverse events rate (RR = 0.78, 95% CI 0.45-1.34) and relapse rate (RR = 1.45, 95% CI 0.66-3.16) were found. Otherwise, the subgroup analysis indicated that the RR was 1.64 (95% CI 0.24-11.36) for low-dose propranolol (1 mg/kg/day), 1.42 (95% CI 1.12-1.80) for medium dose (2 mg/kg/day) and 1.46 (95% CI 1.17-1.82) for high dose (3 mg/kg/day), but the high dose had higher adverse events rate than medium dose, with 3.60% and 86.22%, respectively. The effectiveness of propranolol therapy among cases of treatment duration less than 6 months (RR = 1.24, 95% CI 1.05-1.47) was inferior to that of treatment duration greater than or equal to 6 months (RR = 1.46, 95% CI 1.11-1.92).This meta-analysis reveals that oral propranolol is superior to other treatments in improving response rate of IH and can be used as the first-line therapy for IH children. A dosage of 2 mg/kg/day propranolol orally may be a good choice for IH. However, further studies are essential.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
jiaolulu发布了新的文献求助10
2秒前
踏雪飞鸿完成签到,获得积分10
3秒前
hannah完成签到,获得积分10
3秒前
songvv发布了新的文献求助10
4秒前
一一一应助Bin_Liu采纳,获得10
5秒前
麻果完成签到,获得积分10
7秒前
OER完成签到,获得积分10
7秒前
伦语完成签到,获得积分20
7秒前
中陆完成签到,获得积分10
8秒前
9秒前
莫西莫西完成签到,获得积分10
11秒前
13秒前
量子星尘发布了新的文献求助10
14秒前
xjh完成签到,获得积分10
14秒前
14秒前
lbnzd8g完成签到,获得积分10
16秒前
中海完成签到,获得积分10
16秒前
Ww完成签到,获得积分10
16秒前
伶俐不二完成签到,获得积分10
16秒前
XIAOJU_U完成签到 ,获得积分10
17秒前
马士全发布了新的文献求助10
18秒前
MQ完成签到,获得积分10
18秒前
单纯血茗发布了新的文献求助10
20秒前
善学以致用应助田南松采纳,获得10
20秒前
不如看海完成签到 ,获得积分10
21秒前
可靠的南露完成签到,获得积分10
22秒前
gg完成签到,获得积分10
22秒前
AU完成签到,获得积分10
24秒前
与淇完成签到,获得积分10
24秒前
开心祯祯完成签到,获得积分10
24秒前
马士全完成签到,获得积分10
25秒前
Qian完成签到 ,获得积分10
25秒前
degre完成签到 ,获得积分10
25秒前
W~舞完成签到,获得积分10
26秒前
我的文献呢应助pz采纳,获得30
27秒前
潇洒的如松完成签到,获得积分10
28秒前
逆流的鱼完成签到 ,获得积分10
29秒前
英俊的铭应助jiaolulu采纳,获得10
32秒前
33秒前
榛糕李完成签到,获得积分10
35秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022