Multicenter Evaluation of the Effectiveness of Systemic Propranolol in the Treatment of Airway Hemangiomas

Abstract

This multisite study of AIH treatment with propranolol demonstrates similar effectiveness to surgical treatment modalities. Propranolol therapy for AIH had no complications, had potentially lower resource utilization, and should be considered a first-line AIH treatment.

Efficacy and rebound rates in propranolol‐treated subglottic hemangioma: A literature review

“…Although 2 mg/kg/d is the most common starting dose, increasing the dose to 3 mg/kg/d resolved the majority of continued symptoms and rebound growth. In addition, other recent investigations support the use of higher starting doses without a reported increase in frequency of adverse effects . There was no significant difference in initial success rates when comparing 3 mg/kg/d to the lower doses.…”

“…Many case reports did not follow the patient to completion of their course of propranolol. The mean length of treatment documented in Elluru et al (15 months) is likely a more accurate representation of current practices, as their study only included cases with long‐term follow‐up through the termination of propranolol . Although this study did not identify rebound growth, it reported 22% of the 27 patients required additional medical or surgical intervention, with only one being a complete nonresponder to propranolol therapy.…”

“…Although propranolol has become more widely accepted as a first‐line treatment in SGH, there are no standardized guidelines regarding treatment duration or optimal dosing. Although most studies indicate that propranolol is efficacious, there have been nonresponders reported, and there is limited information regarding rebound rates upon weaning or terminating propranolol . The occurrence of rebound growth in the subglottis could lead to significant airway compromise of the patient.…”

“…Although most studies indicate that propranolol is efficacious, there have been nonresponders reported, and there is limited information regarding rebound rates upon weaning or terminating propranolol. [19][20][21][22] The occurrence of rebound growth in the subglottis could lead to significant airway compromise of the patient.…”

Subglottic infantile haemangioma: A rare but important consideration in young infants presenting with stridor

“…5 The efficacy of propranolol is striking, with the elimination of stridor within 24 h of initiation of therapy being seen in 85% of infants in one study. 6 Propranolol is given generally at a dose of 3 mg/kg/day. 7 Adverse incidents reported include bradycardia, hypotension, bronchospasm and hypoglycaemia.…”