TOPLINE:

An estimated 2.31 million infantile hemangioma (IH)-related healthcare visits occurred in the US from 2009 to 2019, with sharp rise in prescriptions for topical timolol, whereas systemic propranolol prescribing remained unchanged.

METHODOLOGY:

• Researchers analyzed 14,076 visits for infants (age ≤ 1 year) from the US National Ambulatory Medical Care Survey data from 2009 to 2019 representing over 434 million visits.
• A total of 0.53% of infants were diagnosed with a hemangioma, which corresponded to 2.31 million US visits for IH.
• The visits were grouped into 5-year periods: 2009-2013 and 2014-2019.
• The study outcome was prescription patterns of beta-blockers including timolol, propranolol, atenolol, nadolol, and acebutolol.

TAKEAWAY:

• IH visits increased from 878,725 during 2009-2013 to 1,431,913 during 2014-2019 (P = .022).
• The number of visits with prescriptions for topical timolol rose from 16,279 to 424,845 between the two periods (P < .001). However, there were no significant differences in prescriptions for systemic beta-blockers between these periods: propranolol (162,323 vs 208,139; P = .652) or less commonly prescribed beta blockers atenolol, nadolol, or acebutolol (23,354 to 103,706; P = .139).
• Significantly higher proportions of visits associated with an IH diagnosis involved a prescription for timolol (18.60%), propranolol (10.28%), or either medication (28.88%) than non-IH visits (0.03%; P  < .001 for all).
• Prescriptions for timolol and/or propranolol were more common among girls (P < .001), non-Hispanic/Latinos (P < .001), metropolitan residents (P = .005), and those seen through referrals than among those who self-referred (P < .001) and patients treated by specialists (P < .001) and solo practitioners (P = .30).

IN PRACTICE:

“US healthcare utilization for IH continued to rise between 2009 and 2019, corresponding to a growing number of cases, increased awareness, timely diagnosis, and more effective treatments for IH,” which is possibly why topical beta-blocker prescriptions have increased, the authors concluded. While “there appears to be a mismatch with concurrently unchanged prescription rates of systemic beta blockers,” they added, “one should consider that the increased diagnosis of IH may reflect a higher proportion of superficial and/or early lesions that will be treated or otherwise respond to the application of timolol.”

SOURCE:

The study was led by Mohsen Afarideh, Department of Dermatology, Mayo Clinic, Rochester, Minnesota. It was published online on August 28 in Pediatric Dermatology.

LIMITATIONS:

Study limitations included lack of longitudinal follow-up and information on severity and complications, inconsistent International Classification of Diseases coding, and potential selection bias. The 2019 American Academy of Pediatrics clinical practice guidelines likely influenced prescription patterns.

DISCLOSURES:

The authors declared having no funding sources or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.