Atenolol treatment for severe Infantile Hemangiomas: a single‐centre prospective study

Alexopoulos, A.; Thanopoulou, I; Dakoutrou, Maria; Georgiadou, E.; Chrousos, G.P.; Kakourou, Talia

doi:10.1111/jdv.14590

Cited by 9 publications

(15 citation statements)

References 8 publications

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“…After full‐text review of the remaining 60 records, 51 articles were removed according to the exclusion criteria. Nine studies were included in the final analysis. These nine studies included three research letters with clear descriptions of the original data, two retrospective studies, one prospective study, one cohort study and two RCT .…”

Section: Resultsmentioning

confidence: 99%

“…The detailed characteristics of the included studies are presented in . A total of 341 IH cases from 9 studies published between 2013 and 2018 were included in this analysis. In these studies, 40 patients were from America, 181 patients were from Asia and 120 patients were from Europe.…”

Section: Resultsmentioning

confidence: 99%

“…The authors reported excellent response with no side effects. Subsequently, several studies have reported their experience in using oral atenolol in IH, especially as an alternative to propranolol …”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of oral atenolol for the treatment of infantile haemangioma: A systematic review

et al. 2018

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Recently, several studies have reported their experience in using oral atenolol in patients with infantile haemangioma (IH), especially as an alternative to propranolol, but the efficacy and safety of oral atenolol has not been evaluated. We searched PubMed (Medline), Central, Embase, Web of Science and EBSCOhost (until May 2018) for the eligible studies reporting more than 10 IH patients who were treated with oral atenolol with detailed original data, including outcomes, regimens and adverse events (AEs). The data was standardised and analysed by using R software with meta-package. A total of 9 of 141 identified articles, including 341 infantile haemangioma patients treated with oral atenolol therapy, were included. The pooled response rate of atenolol was 0.90 (95% CI: 0.85-0.93), and the rebound rate was 0.11 (95% CI: 0.08-0.16). Among the 341 patients, 44 patients were switched to atenolol therapy from propranolol due to adverse events. The response rate of subsequent atenolol treatment was 90.9% (40/44). Regarding AEs, 141 patients reported 177 episodes of AEs, and the pooled rate was 0.26 (95% CI: 0.12-0.47). Gastrointestinal symptoms (e.g. constipation, diarrhoea and vomiting) were the most frequent AEs (22.6%). Widely known propranolol-related AEs, including hypoglycaemia, bronchospasm, bradycardia and hypotension, were not recorded. Overall, atenolol appears to be an effective and safe therapy for the treatment of IH and may be a promising alternative to propranolol.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of oral atenolol for the treatment of infantile haemangioma: A systematic review

et al. 2018

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“…8 We also observed overexpression of the IFNR1 receptor, participating in the activation of the interferon-dependent path, which is responsible for the occurrence of paradoxical psoriasis during anti-TNF medicine therapy. 9 Such observation may partially explain the occurring loss of response in the therapy with the use of TNF inhibitors and constitute the basis to elaborate a new therapeutic strategy.…”

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confidence: 99%

“…2,[6][7][8] We performed a comparative study, in order to evaluate the efficacy and safety of treatment, between a group of infants with hemangiomas who received atenolol (n = 26) and a previously described group of infants in our department, who received propranolol for the treatment of their hemangiomas (n = 28). 9,10 Infants with problematic IHs during the proliferative phase were considered for inclusion in both studies. Exclusion criteria included patients with a history of cardiovascular, neurological disorders or renal function impairment.…”

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confidence: 99%

Atenolol treatment for severe infantile hemangiomas: comparison with a propranolol group of our centre

Dakoutrou

Alexopoulos

Miligkos

et al. 2019

Acad Dermatol Venereol

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Efficacy and Safety of Propranolol vs Atenolol in Infants With Problematic Infantile Hemangiomas

Chen

Yang

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEPropranolol has become the first-line therapy for problematic infantile hemangiomas (IHs) that require systemic therapy. However, different adverse events have been reported during propranolol treatment. The positive efficacy and safety of atenolol raise the question of whether it could be used as a promising therapy for IH.OBJECTIVE To compare the efficacy and safety of propranolol vs atenolol in infants (between age 5 and 20 weeks) with problematic IHs who required systemic therapy. DESIGN, SETTING, AND PARTICIPANTS This was a prospective, multicenter, randomized, controlled, open-label clinical trial conducted in collaboration among 6 separate investigation sites in China from February 1, 2015, to December 31, 2018. A total of 377 patients met the criteria for inclusion and were randomized to the propranolol (190 [50.4%]) and atenolol (187 [49.6%]) groups. Data were analyzed in June 2020.INTERVENTIONS Participants were randomized to receive either propranolol or atenolol for at least 6 months. They completed efficacy assessments at 2 years after the initial treatment. MAIN OUTCOMES AND MEASURESThe primary outcome was any response or nonresponse at 6 months. The key secondary outcome was changes in the hemangioma activity score. RESULTSOf 377 participants, 287 (76.1%) were female, and the mean (SD) age was 10.2 (4.0) weeks in the propranolol group and 9.8 (4.1) weeks in the atenolol group. After 6 months of treatment, in the propranolol and atenolol groups, the overall response rates were 93.7% and 92.5%, respectively (difference, 1.2%; 95% CI, −4.1% to 6.6%). At 1 and 4 weeks after treatment, and thereafter, the hemangioma activity score in the atenolol group aligned with the propranolol group (odds ratio, 1.034; 95% CI, 0.886-1.206). No differences between the propranolol group and atenolol group were observed in successful initial responses, quality of life scores, complete ulceration healing times, or the rebound rate. Both groups presented a similar percentage of complete/nearly complete responses at 2 years (82.1% vs 79.7%; difference, 2.4%; 95% CI, −5.9% to 10.7%). Adverse events were more common in the propranolol group (70.0% vs 44.4%; difference, 25.6%; 95% CI, 15.7%-34.8%), but the frequency of severe adverse events did not differ meaningfully between the groups. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, when compared with propranolol, atenolol had similar efficacy and fewer adverse events in the treatment of infants with problematic IHs. The results suggest that oral atenolol can be used as an alternative treatment option for patients with IH who require systemic therapy.

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Atenolol treatment for severe Infantile Hemangiomas: a single‐centre prospective study

Cited by 9 publications

References 8 publications

Efficacy and safety of oral atenolol for the treatment of infantile haemangioma: A systematic review

Efficacy and safety of oral atenolol for the treatment of infantile haemangioma: A systematic review

Atenolol treatment for severe infantile hemangiomas: comparison with a propranolol group of our centre

Efficacy and Safety of Propranolol vs Atenolol in Infants With Problematic Infantile Hemangiomas

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