Efficacy and safety of combined oral propranolol, oral prednisolone, and topical timolol versus combination of oral propranolol plus topical timolol in treating infantile hemangioma.

Authors

  • Aqsa Rafique Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.
  • Muhammad Shahid Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.
  • Saifullah Sheikh Allied I Hospital, Faisalabad Medical University, Faisalabad.
  • Faizan Asghar King Edward Medical University.
  • Nadia Ali Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.
  • Shakeel Ahmad Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.
  • Muhammad Ahsan Nusrat Fateh Ali Khan Hospital, Faisalabad

DOI:

https://doi.org/10.29309/TPMJ/2025.32.07.9830

Keywords:

Combination Therapy, Infantile Hemangioma, Prednisolone, Propranolol, Timolol

Abstract

Objective: To determine the efficacy and safety of combined oral propranolol, oral prednisolone, and topical timolol in treating infantile hemangioma. Study Design: Randomized Clinical Trial. Setting: Department of Dermatology, Allied II (DHQ) Hospital Faisalabad Medical University, Faisalabad. Period: October 23 to August 24. Methods: A total of 68 infants aged 1 month to 5 years with clinically diagnosed infantile hemangiomas (IHs) were enrolled through non-probability consecutive sampling. Infants with comorbidities such as asthma, cardiac disease, or prior treatment were excluded. Participants were randomized into two groups: Group D (dual therapy) received dual therapy (oral propranolol and topical timolol only) while Group T (Triple) received triple therapy (oral propranolol, oral prednisolone, and topical timolol). Patients were followed biweekly for the first month and monthly thereafter for three months. Treatment efficacy was assessed based on lesion regression, while secondary outcomes included side effects and parental satisfaction. Results: Improvement (25–100% reduction) was observed in 88% of patients in Group D and 97% of patients in Group T, But not statistically significant. However, the incidence of mild-to-moderate side effects was notably higher in Group D (32%) compared to Group T (6%), which was statistically significant. Conclusion: Both the combinations of oral propranolol, oral prednisolone, and topical timolol and the combination of oral propranolol and topical timolol demonstrated high efficacy, but triple therapy had better results with less complications.

Author Biographies

Aqsa Rafique, Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.

MBBS, FCPS (Pediatrics), Fellow Pediatric Dermatology, 

Muhammad Shahid, Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.

MBBS, FCPS, HOD Dermatology, 

Saifullah Sheikh, Allied I Hospital, Faisalabad Medical University, Faisalabad.

MBBS, FCPS, Associate Professor, 

Faizan Asghar, King Edward Medical University.

MBBS, Medical Officer, Maple Medical Center, 

Nadia Ali, Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.

MBBS, FCPS, Consultant Dermatologist, 

Shakeel Ahmad, Allied II (DHQ) Hospital, Faisalabad Medical University, Faisalabad.

MBBS, FCPS, Consultant dermatologist, 

Muhammad Ahsan, Nusrat Fateh Ali Khan Hospital, Faisalabad

MBBS, PGPN-Post Grad Pediatric Nutrient, Registrar Medical-Pediatric Emergency, 

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Published

2025-07-01

Issue

Section

Origianl Article