Topical Timolol Linked to Fewer Systemic Adverse Events in Superficial Infantile Haemangiomas

A systematic review and meta-analysis published in Acta Paediatrica compared oral propranolol with topical timolol for superficial infantile haemangiomas. Investigators searched five databases through April 23, 2026, and included seven randomized controlled trials involving 428 infants. Two reviewers independently screened studies, extracted data and assessed risk of bias. Primary outcomes were overall response rate and systemic adverse events, pooled using fixed-effect models.

Overall response rates did not differ significantly between treatments (RR 1.09, 95% CI 0.97–1.23; p = 0.17), with no observed statistical heterogeneity (I² = 0%). Topical timolol was associated with a lower risk of systemic adverse events than oral propranolol (RR 0.35, 95% CI 0.20–0.59; p < 0.0001; I² = 9%), representing a 65% relative reduction.

These findings support consideration of topical timolol for superficial lesions, but should not be extrapolated to other haemangioma types. A nonsignificant response difference does not establish therapeutic equivalence. The available abstract does not report absolute adverse-event rates, event types, treatment regimens, follow-up duration or risk-of-bias results; full text was unavailable for assessment.