Oral atenolol compared to oral propranolol for infantile hemangioma - Medwave

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Published on 7 de diciembre de 2023 | http://doi.org/10.5867/medwave.2023.11.2753

Oral atenolol compared to oral propranolol for infantile hemangioma

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Atenolol compared to propranolol for infantile hemangioma.

Atenolol compared to propranolol for infantile hemangioma
Patients	Patients with infantile hemangioma
Intervention	Oral atenolol monotherapy
Control	Oral propranolol monotherapy
Outcomes	Absolute effect*		Relative effect (95% CI)	Certainty of evidence (GRADE)
	Propranolol	Atenolol
	Difference: patients per 1000
Complete remission	826 per 1000	793 per 1000	RR 0.96 (0.87 to 1.05)	⊕⊕ΟΟ^I Low
Complete remission	Difference: 33 less(Margin of error: from 107 minus to 41 plus)		RR 0.96 (0.87 to 1.05)	⊕⊕ΟΟ^I Low
Decrease in Hemangioma Activity Score**	The decrease in Hemangioma Activity Score was, on average, 0.08 standard deviations lower in the intervention group compared to the control.		-	⊕⊕ΟΟ^I Low
Decrease in Hemangioma Activity Score**	SMD: 0.08 less(Margin of error: from 0.29 less to 0.13 more)		-	⊕⊕ΟΟ^I Low
Post-treatment relapse	128 per 1000	77 per 1000	RR 0.60 (0.32 to 1.13)	⊕⊕ΟΟ^I Low
Post-treatment relapse	Difference: 51 less(Margin of error: 87 less to 17 more)		RR 0.60 (0.32 to 1.13)	⊕⊕ΟΟ^I Low
Adverse events☨	662 per 1000	550 per 1000	RR 0.83 (0.46 to 1.51)	⊕⊕ΟΟ^I Low
Adverse events☨	Difference: 112 less(Margin of error: 358 minus to 338 plus)		RR 0.83 (0.46 to 1.51)	⊕⊕ΟΟ^I Low
Severe adverse events☨☨	23 per 1000	14 per 1000	RR 0.61 (0.15 to 2.51)	⊕⊕ΟΟ^I Low
Severe adverse events☨☨	Difference: 9 less(Margin of error: from 19 less to 34 more)		RR 0.61 (0.15 to 2.51)	⊕⊕ΟΟ^I Low
Margin of error: 95% confidence interval (95% CI).RR: Relative risk.SMD: Standardized mean difference.GRADE: Grades of evidence from the GRADE Working Group (see below).The risks/averages with propranolol are based on the risks/averages of the control group in the studies. The risk/average with atenolol (and its margin of error) is calculated from the relative effect/mean difference (and its margin of error).* The Hemangioma Activity Score corresponds to a validated instrument, which is calculated as a score based on three subitems: deep swelling, color, and ulceration of the hemangioma. The calculated score can range from zero to eight points, and a change in one point is considered clinically relevant [25].☨ The outcome "adverse events" included gastrointestinal symptoms (diarrhea, nausea), sleep disturbances, agitation, and/or cold extremities.☨☨ The outcome "severe adverse events" included the presence of bronchial hyperreactivity, hypotension, asymptomatic bradycardia, hypoglycemia, and/or hyperkalemia.I Two levels of certainty of evidence were downgraded for risk of bias and imprecision. The confidence interval limits in the outcomes are wide, favoring one therapy or another at each confidence interval limit.