מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Most young children with problematic cutaneous hemangiomas respond to treatment with systemic corticosteroids, according to a meta-analysis of case reports.
Reporting in the September issue of the Archives of Dermatology, Dr. Ilona J. Frieden of the University of California at San Francisco and colleagues note there is an absence of prospective studies of systemic corticosteroid therapy for this condition.
However, the investigators point out that "many individual case reports and case series have been published," and they ultimately used pooled data from 10 case series to investigate the efficacy of corticosteroid therapy.
Altogether, 184 children under the age of 2 years were included in the review. All had enlarging problematic cutaneous hemangiomas and were treated with systemic corticosteroids.
Various agents, including prednisolone and methylprednisolone, were used. The mean prednisone equivalent daily dose was 2.9 mg/kg and the mean treatment duration before tapering was 1.8 months. No life-threatening adverse events were reported.
The mean response rate was 84% and the mean rebound rate was 36%. There was a significant difference between the mean dose in responders and that in nonresponders (p < 0.001). Daily dosages ranging from 2 to 3 mg/kg led to a 75% response and doses above 3 mg/kg led to a 94% response, albeit with more adverse events. Dosages below 2 mg/kg resulted in fewer responses, fewer adverse events and a 70% rebound rate.
The researchers call for prospective studies of the treatment, but conclude that given the response rate in appropriately selected and treated infants, "the benefit-risk ratio is acceptable."
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