Chronic wounds may respond to topical timolol

By Rob Goodier

Chronic wounds that do not heal may respond to topical timolol, a topical beta-adrenergic receptor antagonist used to treat glaucoma, a new case series suggests.

"Physicians may wish to consider timolol as an alternative treatment option for refractory wounds that have failed more conventional therapy. Additional studies will help to support timolol use earlier in treatment algorithms," senior author Dr. Robert Kirsner, chief of dermatology at the University of Miami School of Medicine in Miami, told Reuters Health by email.

The researchers treated five patients with recalcitrant wounds and found that all five improved with timolol. Three of the five healed completely and two saw reductions in the area of their wounds, they report online October 30 in JAMA Dermatology. After seven weeks, the mean reduction in wound area was 78.2%.

The regimen was one drop of 0.5% timolol solution applied every 2 cm around the edge of the wound. The solution dried and then the wound was dressed. Treatment occurred either daily or weekly for four to eight weeks.

Recent research in animals suggests that targeting beta-adrenergic receptors and catecholamines could improve the healing process, the researchers write.

"Catecholamines inhibit wound healing and this finding was shown by various groups. Therefore, this report makes sense. I would suggest to conduct larger trials," said Dr. Marc Jeschke, who directs the Ross Tilley Burn Centre at the Sunnybrook Health Sciences Centre in Toronto, Canada, and was not involved in the research.

"This is promising and interesting; should be safe as well," Dr. Jeschke told Reuters Health by email.

SOURCE: http://bit.ly/17IGwao

JAMA Dermatol 2013.