Comparison of Two Formulations of Topical Timolol for the Treatment of Infantile Hemangiomas

Abstract

This report compares the efficacy of timolol maleate 0.5% eyedrops (TM) with that of timolol maleate 0.5% ophthalmic gel-forming solution in the treatment of infantile hemangiomas (IHs). Sixty-six patients undergoing treatment with topical timolol were retrospectively reviewed; our results revealed similar therapeutic efficacies for both types of timolol formulations. Early treatment initiation (<3 mos) and superficial lesions correlated with better treatment response. TM eyedrops may be a more cost effective, equally efficacious modality of treatment for IHs.

Topical timolol for superficial cutaneous infantile hemangiomas in very preterm infants

“…It achieves quicker and more complete involution of IH than naturally, but with low potential for adverse events in especially vulnerable patients. Topical timolol therapy may have some adverse effects, although they occur very rarely: bradycardia, hypotensia, apnea, sleep disturbances and hypothermia 28,29 . In most studies dealing with efficacy and safety of topical timolol for IHs these effects have not been recorded at all 13,28 .…”

“…Topical timolol therapy may have some adverse effects, although they occur very rarely: bradycardia, hypotensia, apnea, sleep disturbances and hypothermia 28,29 . In most studies dealing with efficacy and safety of topical timolol for IHs these effects have not been recorded at all 13,28 . In the study conducted on 103 infants treated with topical timolol for IHs, 22 infants were considered at high-risk for adverse effects for any reason: young at initiation of therapy (less than 4 weeks corrected age); those receiving more than two drops per day; application to a site with potential for high systemic absorption (mucosal, ulcerated IH, under occlusion).…”

Topicalbeta‐blockersin dermatologic therapy

“…However, since 0.5% topical timolol appears to be the most widely used formulation, 2 , 7 , 8 a meta‐analysis conducted by Ng et al in 2016, focused more extensively on the therapeutic protocols rather than on the concentrations, showing that encouraging results are indeed possible with different 0.5% topical timolol administration protocols (1 drop BID, 2 drops BID, 3 drops TID/QID, 3 drops TID), as Global Assessment Score greater than 3 (which indicates an acceptable clinical improvement) was registered in 47% up to 88% of cases. 9 …”

“…Moreover, two recent meta‐analyses by Zheng and by Lin clearly assessed once again 0.5% topical timolol greater efficacy and safety compared to simple observation. 7 , 8 …”

Inhibitory effect of timolol on topical glucocorticoid‑induced skin telangiectasia

“…It is a non-selective and powerful β-blocker used to treat ocular hypertension, angina, tachycardia and glaucoma ( 8 ). In recent years, timolol solution has been used by dermatologists to treat infant hemangioma ( 9 ). In the present study, the effects of timolol maleate (0.5%) eye drops (TMEDs) in patients with FCAD and a rabbit model of telangiectasia were documented.…”