Intralesional injection of bevacizumab versus triamcinolone acetonide in infantile hemangioma.

Background

Infantile hemangioma (IH) in most cases can be a self-limited condition; however, it may be ulcerated, infected, causing organ function disability and even death. Vascular endothelial growth factor (VEGF) has a role in IH. Bevacizumab is a monoclonal antibody against VEGF-A.

Objectives

We aimed to evaluate and compare the efficacy of intralesional injection of bevacizumab versus triamcinolone acetonide (TAC) in IH.

Methods

Thirty patients with IH were included in this study, divided into two equal groups, and treated with intralesional injection; the first group by bevacizumab and the second group by TAC. The injections in both groups were given every 4 weeks for six sessions. Assessment of the clinical response was done by the hemangioma activity score (HAS) and visual analog scale (VAS).

Results

Both treatment modalities gave similar initial improvement after three sessions. However, with continuing injection sessions, bevacizumab reached a response's plateau and TAC gave better significant results after six injection sessions reading both HAS (p = .0017) and VAS (p ≤.001).

Conclusion

Both intralesional injection of bevacizumab and TAC were safe and effective treatments in early proliferative IH after three sessions, however, TAC injection was significantly better than bevacizumab after six sessions.