Oral propranolol in infantile hemangiomas: Analysis of factors that affect the outcome

Abstract

Aim: The primary treatment for the subset of infantile hemangiomas (IHs) which develops complication is pharmacological intervention, and propranolol has become a popular choice. Here, we evaluated the efficacy and safety of propranolol in a clinical cohort of IHs and analyzed clinical characteristics associated with a good outcome. Materials and Methods: We retrospectively reviewed a total of 52 IHs patients, between ages 1 and 48 months (median age: 7.5 months), who were treated with oral propranolol, with dose ranging from 2 to 3 mg/kg/day. Efficacy was evaluated using mean percentage reduction, visual analog scale (VAS), and parental satisfaction levels at week 2 and months 1, 2, 6, and 12. The adverse effects were noted and responses after 6 months were graded. Statistical analyses of the outcome were also performed for the responses with regard to age at propranolol initiation, site of lesion, and mean duration of treatment. Results: A therapeutic response with at least 50% mean percentage reduction in size was noted in 84.6% at the end of 6 months. VAS score and parental satisfaction levels correlated well with mean percentage reduction (63.7 ± 15.6) at 6 months. Patients aged <6 months and those with cephalic lesions exhibited a greater therapeutic response rate with shorter overall mean duration of the treatment. Conclusions: Oral propranolol at 2–3 mg/kg/day dosing has shown to be effective and safe for IHs in pediatric age group. Intervention in the early proliferative phase, with especially, the cephalic lesions result in better resolution rates with shorter duration of overall treatment.

Treatment outcomes of oral propranolol in the treatment of periocular infantile capillary hemangioma and factors predictive of recurrence and incomplete resolution

“…The rate of resolution is variable in several studies, partial resolution (60%–85%) being higher than complete resolution (25%–40%). [ 17 18 19 20 21 22 31 32 33 ] In our series, complete resolution was noted in 46.43% while >50% reduction in size was noted in 25%. 28.57% showed a reduction <50% of the original lesion.…”

“…The rate of recurrence/rebound growth following discontinuation of treatment either after complete resolution or in between during treatment has been reported to be 10%–30%. [ 31 32 33 ] The low recurrence rate in our series (14.28%) could be attributed to the smaller sample size. Many of the factors like LBW, superficial IHs seen in the recurrence subgroup were also commonly found in the partial resolution subgroup, as observed by Chang et.…”

New Insights into Cervicofacial Vascular Anomalies

“…Another indication for early surgery is the prevention of growth disturbances in the involved structures to ensure their proper development. Additionally, surgery is indicated for the treatment of sequelae resulting from hemangiomas (e.g., ulceration after rapid involution) [ 19 ].…”

Hemangioma: Recent Advances

“…Infants younger than 8 weeks of age should be admitted for inpatient initiation of treatment for close monitoring 17 . Early treatment during the proliferative phase is thought to be associated with improved outcomes 18 . Over 90% of IHs respond to propranolol with reduction in size and color.…”