Publication:

Comparative study in treatment of haemangioma with oral propranolol and combination effect of oral propranolol and topical timolol solution

Background Haemangioma of infancy usually regresses on its own but recently there has been trend of use of beta blockers like propranolol. Here we assess the improvement in efficacy of combination of propranolol with timolol in decreasing lesion size and colour change. And assess whether the combination decreases the duration of the treatment.

Methods Total of 40 patients were included in our study with surface haemangioma under 12 years. Divided in to two groups of 20 each oral propranolol and timolol and propranolol only, treated for 6 months and were assessed by monthly measurements of lesion dimensions using measuring tape, USG and colour changes noted by clinical photographs on monthly basis. VAS scale was used to grade the improvements. Comparisons were made between the groups with statistical analysis.

Results VAS grade comparisons were insignificant p>0.05. Mean treatment duration was 4.65±2.601 months for Propranolol with timolol group and 5.50±3.171 months for propranolol only group. Statistically significant outcomes between 2 groups were noted in the depth category and total volume reduction of the lesion with p=0.019 and 0.033 respectively, in the subset of 0-12 months only with p=0.038.

Conclusions Clinically there is Volumetric reduction in terms depth reduction and a decrease in duration of treatment. Propranolol 2-3 mg/kg and Timolol solution of 0.5% applied thrice over the lesion was well tolerated without any serious adverse events. The combination therapy fails to demonstrate a statistically approvable shorter period of treatment as well as better efficacy when compared to oral propranolol alone.