Meta-analysis of the efficacy and safety of oral atenolol versus oral propranolol in the treatment of infantile hemangioma
10.3760/cma.j.cn114453-20210927-00394
- VernacularTitle:口服阿替洛尔对比口服普萘洛尔治疗婴幼儿血管瘤疗效及安全性的meta分析
- Author:
Jianmin ZHENG
1
;
Zhisheng ZHU
;
Chaoyang WANG
;
Shize ZHU
Author Information
1. 福建医科大学附属第二医院整形外科，泉州 362000
- Keywords:
Hemangioma;
Infant;
Child;
Adrenergic beta-antagonists;
Propranolol;
Atenolol;
Meta-analysis
- From:
Chinese Journal of Plastic Surgery
2022;38(3):275-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the difference of the efficacy, safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:A comprehensive search was conducted on the English databases Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform (https: //clinicaltrials.gov) and on the Chinese databases CNKI, CBM, VIP, Wanfang Data from January 2008 to June 2021, according to our defined inclusion and exclusion criteria, randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis, and the outcome indicators were treatment efficiency, incidence of adverse reactions, and recurrence rate. Meta-analysis was performed by using RevMan 5.3 software, and sensitivity analysis of the result was performed, and the main outcome indicators were tested for publication bias (Egger’s test) by using Stata 16 software.Results:Finally, 5 randomized controlled trials references were included. Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma ( RR=0.93, 95% CI 0.84-1.02, P=0.110). There was a statistically significant difference in the overall incidence of adverse reactions ( RR=0.78, 95% CI 0.61-0.99, P =0.040), bronch-related and central nervous system related to β 2-blockade( RR=0.55, 95% CI 0.40-0.76, P<0.001) adverse reactions, which were lower in the atenolol group than in the propranolol group; there was a statistically significant difference in the recurrence rate ( RR=0.57, 95% CI 0.39-0.84, P=0.005), which was lower in the atenolol group than in the propranolol group. The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis, and the conclusion obtained were unchanged, suggesting that the result of the meta-analysis were stable and reliable. The Egger’s test showed that P=0.502, which suggested that there was no obvious publication bias. Conclusions:In the treatment of infantile hemangioma, oral atenolol has equivalent efficacy compared with oral propranolol, with less overall incidence of adverse reactions (which can reduce the incidence of bronch-related and central nervous system adverse reactions) and lower recurrence rate.
