Comparing HMME-PDT and Cynergy dual-wavelength laser in the treatment of facial PWS

Peng, Xi; Ye, Tinglu; Yu, Bo; Liu, Xiaoming; Lan-Ting, Liu

doi:10.1016/j.pdpdt.2021.102703

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…It is likely that this was due to a lack of dynamic cooling technique during PDL which could offer better efficacy and fewer side effects. In Peng et al’s ( 37 ) study, there existed no significant difference in the incidence of side effects between different types of PWS in PDT and PDL group. Overall, compared with PDL, PDT might be an alternative approach for treating these patients and reaching a great therapeutic effect with few side effects.…”

Section: Discussionmentioning

confidence: 89%

“…Evans et al ( 15 ) suggested that HMME-PDT is at least as effective as 585 nm PDL in terms of blanching and adverse effects. Four studies analysis demonstrates that the therapeutic effect of PDT was better than that of PDL therapy under the different evaluation criteria ( 17 , 21 , 23 , 37 ). Significantly, PDT is more effective than PDL for purple flat lesions ( 17 , 23 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

“…Four studies analysis demonstrates that the therapeutic effect of PDT was better than that of PDL therapy under the different evaluation criteria ( 17 , 21 , 23 , 37 ). Significantly, PDT is more effective than PDL for purple flat lesions ( 17 , 23 , 37 ). However, PDL is more appropriate for younger patients and superficial lesions and unsuitable for patients with nodular lesions or Fitzpatrick skin types IV or V. There was a wide range of side effects reported in different studies regarding PDT and PDL.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Huang

2023

Front. Med.

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BackgroundPort wine stains (PWS) often cause cosmetic effects and psychological distress. Pulsed dye lasers (PDL) and photodynamic therapy (PDT) are the most commonly used treatments. PDL is still the “gold standard” of therapy to date. However, its shortcomings have become apparent as clinical applications have increased. PDT has been proven as an alternative to PDL. Patients with PWS still lack enough evidence about PDT to make informed treatment decisions.ObjectiveThe purpose of this systematic review and meta-analysis was to assess the safety and effectiveness of PDT for PWS.MethodsThe online datasets, comprising PubMed, Embase, Web of Science, and the Cochrane Library, were searched for meta-analysis-relevant publications. Two reviewers separately evaluated the risk of bias in each listed study. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the treatment and safety outcomes.ResultsOur search retrieved 740 hits and only 26 studies were finally included. Among the 26 studies included, 3 were randomized clinical trials, and 23 were prospective or retrospective cohort investigations. Based on a gathered assessment, the percentage of individuals achieving a 60% improvement was estimated to be 51.5% [95% confidence interval (CI): 38.7–64.1; I2 = 83.8%] and a ≥75% improvement was 20.5% (95% CI: 14.5–26.5; I2 = 78.2%) after 1–8.2 treatment sessions (GRADE score: very low). Due to the statistical diversity of the meta-analysis, a subgroup assessment was performed to determine the sources of diversity. The collected findings indicated that the impact of PDT on enhancing the medical effectiveness of PWS was significant in different treatment sessions, different types of ages, different locations of PWS, and different types of PWS. Pain and edema occurred in most patients. Hyperpigmentation was present in 7.9–34.1% of the patients in 17 studies. Photosensitive dermatitis, hypopigmentation, blister, and scar were infrequently reported, with 0–5.8% incidences.ConclusionPhotodynamic therapy is recommended as a safe and effective treatment for PWS based on the current evidence. However, our findings are based on poor-quality evidence. Therefore, comparative investigations of a large scale and high quality are necessary to support this conclusion.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Huang

2023

Front. Med.

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“…14 PWS occurs mostly in the face and neck area but also in the trunk and limbs. 3 Though PDT showed a more satisfactory efficacy than PDL in the treatment of PWS, 11,15 the efficacy of each patient is not the same after receiving HMME- Exploring comprehensively the factors affecting efficacy can not only provide patients with the prediction of efficacy and improve their treatment compliance but also choose the best treatment plan for patients to improve the efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…9 Since 2017 China Food and Drug Administration approved a new generation of photosensitizer-Hematoporphyrin monomethyl ether (HMME) application in treating PWS, owing to its fewer side effects, higher efficacy, safety, and specificity. 10 Though HMME-PDT might show a better response for PWS than PDL, 11 the efficacy of it is uncertain and difficult to predict. There are several studies have already begun to explore possible factors affecting the efficacy of hemoporfin-mediated photodynamic therapy (HMME-PDT) for PWS, but the results are not entirely in agreement.…”

mentioning

confidence: 99%

Analysis of related factors affecting hemoporfin‐mediated photodynamic therapy for port‐wine stain: A retrospective study

Chen

Gui

Sun

et al. 2023

Photoderm Photoimm Photomed

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BackgroundHemoporfin‐mediated photodynamic therapy (HMME‐PDT) is currently considered one of the most promising therapies for port‐wine stain (PWS). However, the efficacy of this is very variable and needs further studies.MethodsA total of 101 patients with PWS in the face, neck, or extremities who received at least 2 HMME‐PDT sessions were included in the study, and correlations of efficacy with age, gender, locations, treatment sessions, and PDL treatment history were analyzed.ResultsThe efficacy of HMME‐PDT in patients with different ages, locations, and different numbers of prior PDL treatment showed constantly significant differences after 1/2/last session (p < .05). The number of treatments was associated with efficacy, and patients who received more than two sessions had a better response than those who underwent two sessions only (p < .001). Ordinal logistic regression analysis confirmed the above‐mentioned associations. Nevertheless, patients of different sex, subtype, and lesion size showed no significant differences.ConclusionsOur studies demonstrated that HMME‐PDT is effective in the treatment of PWS. The more prior PDL treatments, older age, lips involvement, PWS on limbs were adverse factors for Hemoporfin‐PDT, while multiple HMME‐PDT sessions can improve effective and response rate. Besides, ambient temperature and lesions temperature should be concerned, local cooling provides some relief from pain but may influence effect.

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Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

Gao,

Nguyen,

Hochman

et al. 2024

Lasers Surg Med

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BackgroundPort wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the “gold standard” for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)‐mediated photodynamic therapy (HMME–PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades.AimTo evaluate whether HMME–PDT is superior to PDL by comparing the clinical efficacies of both modalities.MethodPubMed records were searched for all relevant studies of PWB treatment using PDL (1988−2023) or HMME–PDT (2007−2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C0), with data weighted by cohort size, was used to evaluate the final efficacy for each modality.ResultA total of 18 HMME–PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME‐PDT studies were minors (<18 years old). A significant portion (21.3%) were young children (<3 years old). Similarly, 33.2% of patients in the PDL studies were minors. A small proportion (9.3%) was young children. The overall clearance rates for PDL were slightly, but not significantly, higher than those for HMME–PDT in cohorts with patients of all ages (C0, 0.54 vs. 0.48, p = 0.733), subpopulations with only minors (C0, 0.54 vs. 0.46, p = 0.714), and young children (C0, 0.67 vs. 0.50, p = 0.081). Regrettably, there was a lack of long‐term data on follow‐up evaluations for efficacy and impact of HMME‐PDT on young children in general, and central nervous system development in particular, because their blood‐brain barriers have a greater permeability as compared to adults.ConclusionPDL shows overall albeit insignificantly higher clearance rates than HMME‐PDT in patients of all ages; particularly statistical significance is nearly achieved in young children. Collectively, current evidence is insufficient to support HMME–PDT as the first choice of treatment of PWBs in young children given: (1) overall inferior efficacy as compared to PDL; (2) risk of off‐target exposure to meningeal vasculature during the procedure; (3) administration of steriods for mitigation of side effects; ‐and (4) lack of long‐term data on the potential impact of HMME on central nervous system development in young children.

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Comparing HMME-PDT and Cynergy dual-wavelength laser in the treatment of facial PWS

Cited by 8 publications

References 16 publications

Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Analysis of related factors affecting hemoporfin‐mediated photodynamic therapy for port‐wine stain: A retrospective study

Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

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