Faurschou et al.1313. Faurschou A, Olesen AB, Leonardi-Bee J, Haedersdal M. Lasers or light sources for treating port-wine stains. Cochrane Database Syst Rev. 2011;(11):CD007152. PMID: 22071834; https://doi.org/10.1002/14651858.CD007152.pub2. https://doi.org/10.1002/14651858.CD00715...
(5 RCTs; 103 participants) |
Pulsed-dye laser and intense pulsed light
|
Participant preference |
Adults and children with port-wine stains |
• Most patients preferred pulsed-dye laser over intense pulsed light |
•N.A. |
Pulsed-dye laser in association with cooling and pulsed dye laser alone
|
Participant preference |
Adults and children with port-wine stains |
• Most patients preferred pulsed-dye laser in association with cooling, rather than pulsed-dye laser alone |
•N.A. |
Pulsed-dye laser and wait-and-see (active monitoring)
|
Clearance |
Children with port-wine stains |
• There was no statistically relevant difference between these two approaches |
•N.A. |
Skin atrophy |
• 3.5 times more frequent with pulsed-dye laser |
•N.A. |
Hypopigmentation |
• 3.0 times more frequent with pulsed-dye laser |
•N.A. |
Aesthetic appearance |
• There was no statistically relevant difference between these two approaches |
•N.A. |
Novoa et al1414. Novoa M, Baselga E, Beltran S, et al. Interventions for infantile haemangiomas of the skin. Cochrane Database Syst Rev. 2018;4(4):CD006545. PMID: 29667726; https://doi.org/10.1002/14651858.CD006545.pub3. https://doi.org/10.1002/14651858.CD00654...
(28 RCTs; 1728 participants) |
Placebo and propranolol
|
Clearance |
Children with hemangiomas of the skin |
• The likelihood of clearance after propranolol 1 mg/kg/day was 13.48 times greater than after placebo • The likelihood of clearance after propranolol 3 mg/kg/day was 16.6 times greater than after placebo |
• Moderate |
Adverse events |
• There was no difference between these two approaches |
• Low |
Redness improvement, proportion of parents who considered that their children still had a problem, proportion of children who considered that they still had a problem, esthetic appearance and requirement for surgical correction |
• There were no studies reporting this outcome |
• N.A. |
Topical timolol and placebo
|
Clearance and subjective measurement of improvement |
Children with hemangiomas of the skin |
• There were no studies reporting this outcome |
• N.A. |
Adverse events (bradycardia) |
• There was no difference between these two approaches |
• Low |
Volume reduction |
• The likelihood of volume reduction after topical timolol maleate was 5.21 greater than with placebo |
• Moderate |
Other measurements of resolution, as assessed by a clinician, at any follow-up: no redness |
• The likelihood of no redness after topical timolol maleate was 8.11 times greater than with placebo |
• Low |
Topical bleomycin and placebo
|
Shrinkage of lesions |
Children with hemangiomas of the skin |
• The shrinkage of lesions after bleomycin was 21 times greater than with placebo |
•N.A. |
Nd:YAG in association with oral propranolol versus Nd:YAG alone
|
Clearance and superficial scars |
Children with hemangiomas of the skin |
• There was no clear difference between these two approaches |
•N.A. |
Novoa et al1414. Novoa M, Baselga E, Beltran S, et al. Interventions for infantile haemangiomas of the skin. Cochrane Database Syst Rev. 2018;4(4):CD006545. PMID: 29667726; https://doi.org/10.1002/14651858.CD006545.pub3. https://doi.org/10.1002/14651858.CD00654...
(28 RCTs; 1728 participants) |
Nd:YAG in association with oral propranolol versus oral propranolol alone
|
Clearance |
Children with hemangiomas of the skin |
• The likelihood of clearance after Nd:YAG + oral propranolol was 8.44 times greater than with propranolol alone |
•N.A. |
Superficial scars |
• There was no clear difference between these two approaches |
•N.A. |
Improvement ≥ 95% |
• The likelihood was 2.83 times greater with Nd:YAG + oral propranolol than with oral propranolol alone |
•N.A. |
Propranolol and prednisolone
|
Risk of complications |
Children with hemangiomas of the skin |
• The risk of complications after oral propranolol was 78% lower than after oral prednisolone |
•N.A. |
Size reduction |
• No clear difference was found |
•N.A. |
Oral propranolol + oral prednisolone versus oral propranolol alone
|
Risk of adverse events |
Children with hemangiomas of the skin |
• The risk of adverse events after oral propranolol was 70% lower than with dual therapy |
•N.A. |
Oral propranolol + oral prednisolone versus oral prednisolone
alone
|
Adverse events |
Children with hemangiomas of the skin |
• No clear difference was found between these two types of treatment |
•N.A. |
Size reduction |
• There was no significant difference between dual therapy and oral prednisolone |
•N.A. |
Oral propranolol versus topical timolol
|
Clearance and subjective measurement of improvement |
Children with hemangiomas of the skin |
• There were no studies reporting this outcome |
• N.A. |
Adverse events (general adverse events) |
• The risk was 7 times higher among participants randomized for propranolol |
• Very low |
Other measurements of resolution, as assessed by a clinician, at any follow-up: no redness |
• There was no statistically relevant difference between these two approaches |
• Low |
Zuurbier et al.1515. Zuurbier SM, Al-Shahi Salman R. Interventions for treating brain arteriovenous malformations in adults. Cochrane Database Syst Rev. 2019;9(9):CD003436. PMID: 31503327; https://doi.org/10.1002/14651858.CD003436.pub4. https://doi.org/10.1002/14651858.CD00343...
(One RCT; 226 participants) |
Intervention and conservative management for treating brain arteriovenous malformations
|
Risk of death or dependence |
Adults with brain arteriovenous malformations |
• 2.53 times greater for patients randomized for intervention |
• Moderate |
Symptomatic intracranial hemorrhage |
• The risk was 6.75 times higher for participants who underwent to intervention |
• Moderate |
Epilepsy |
• There was no statistically relevant difference between them |
• Moderate |