Propranolol therapy in infantile hemangioma: correlation of age and duration of treatment to the outcomes

Al-Mayoof, Ali Farooq; Joda, Ali Egab; Almushhadany, Osama Esmaeel

doi:10.1186/s43159-019-0007-7

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…Topiramate and propranolol similarly prevents migraine headaches [41], and propranolol reduces the monthly headache frequency [42]. The treatment with propranolol has been investigated in infants and children [43][44][45][46][47][48][49][50]. Propranolol reduces the recurrences of supraventricular tachycardia in infants [43].…”

Section: Discussionmentioning

confidence: 99%

“…Propranolol treatment reduces the symptoms of heart failure in infants with congenital heart disease [45], and treats hypoxemic spells in infants with tetralogy of Fallot [46]. Propranolol treats infantile haemangioma; a higher response-rate can be gained with early treatment and prolonged course of therapy [47] and propranolol reduces infant haemangioma size without producing adverse-effects [48]. Low dose of propranolol is safe and effective for treating problematic proliferating infantile haemangioma [49] and shorts the natural course of infantile haemangioma [50].…”

Section: Discussionmentioning

confidence: 99%

“…Propranolol is effective in treating hypoxemic spells in 80% of infants with teratology of Fallot and the effectiveness is greater with large doses of propranolol [46]. Propranolol treatment is safety and efficacy in infantile haemangioma and a higher response-rate can be gained with early treatment and a prolonged course of therapy [47]. Propranolol is a useful and safe treatment option for severe or complicated infantile haemangioma achieves a rapid and significant reduction in haemangioma size, and no adverse-effects are observed [48].…”

Section: Treatment With Propranolol In Infants and Childrenmentioning

confidence: 99%

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Clinical Pharmacology of Propranolol in Infants and Children

Pacifici¹

2021

JCLR

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Propranolol is α nonselective β adrenergic receptor antagonist with equal affinity for β1 and β2 adrenergic receptors, lacks intrinsic sympathomimetic activity, and does not block α receptors. Propranolol is absorbed following oral administration and consists in two enantiomers, the (-) enantiomer is the active form and is cleared from the body more slowly than the inactive (+) enantiomer. Much of propranolol is metabolized in the liver and the metabolites of propranolol are 4-hydroxypropranolol, 5-hydroxypropanolol, N-desisopropranol, and propranolol β-D-glucuronide. The oral dose of propranolol hydrochloride is 250 to 750 µg/kg thrice-daily in infants and in children it is 200 to 500 µg/kg thrice-daily or 4 times-daily. Propranolol has been found efficacy and safe in infants and children but may induce adverse-effects. The elimination half-life of propranolol is about 15 hours in term and preterm infants and the distribution volume of propranolol is larger than the water volume. Propranolol interacts with drugs. Halofenate, phenytoin, phenobarbitone, rifampicin, and ethanol which affect the clearance of propranolol, and chlorpromazine and cimetidine inhibit the metabolism of propranolol. The prophylaxis, treatment, and trials with propranolol have been extensively studied in infants and children. Propranolol crosses the human placenta but it does not equilibrate between the maternal and foetal compartment and migrates into the beast-milk. The aim of this study is to review the published of propranolol dosing, efficacy and safety, effects, adverse-effects, metabolism, pharmacokinetics, interaction with drugs, prophylaxis, treatment and trials in infants and children and propranolol transfer across the human placenta and migration into the beast-milk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Treatment With Propranolol In Infants and Childrenmentioning

confidence: 99%

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Clinical Pharmacology of Propranolol in Infants and Children

Pacifici¹

2021

JCLR

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“…For hemangiomas that require treatment, the best time to start is before or immediately after the onset of obvious risks of complications [24]. It was found that IH treatment in the proliferative phase allows achieving the best result [25,26].…”

Section: Introductionmentioning

confidence: 99%

Influence of Age and Morphological Features on the Clinical Manifestations and Treatment Efficacy of Hemangiomas in Children

Vivcharuk

Davydenko

2021

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Background. Infantile hemangioma (IH) is a neoplasm that is most common in childhood. Morphologically, hemangiomas are divided into superficial, deep and mixed, focal, segmental, indeterminate and multifocal. The course of IH includes phases of rapid growth followed by slow involution. The degree of involution of hemangioma is variable. Hemangiomas can lead to the appearance of permanent deformities of soft tissues or functional disorders, especially when localized on the face and vital structures. Clinical heterogeneity of hemangiomas creates significant difficulties for physicians in resolving issues of treatment tactics. Specific characteristics of the clinical behavior of hemangiomas of various morphological types can be crucial in the choice of management tactics for such patients. Objectives. The aim of the work is to study the effect of different morphological types of hemangioma in children on the effectiveness of treatment of age-related clinical features. Subjects and Methods. The study group consisted of 100 children in age from birth to 6 years who have hemangiomas of different morphological types and localizations and did not receive previous treatment. All research participants for hemangioma severity scale (HSS), hemangioma activity scale (HAS), visual analogue scale (VAS) before, during and after treatment were scored. Serum levels sFas/sFasLs before and during treatment evaluated. Results. With increasing the child’s age, the indicator as for HAS reliably decreases for all types of hemangiomas. In all types of hemangiomas predominantly an active growth took place. An abortive growth in 10% of patients was noted. For focal hemangiomas, the indicator of sFas decreases with age, and for multifocal hemangiomas it increases. In both cases, there is an increase in the sFasL indicator with increasing age of the child. In our study, in age group before 1 year in the factor structures, “age” factor was considered to be the main one and manifested by a decrease in the activity of hemangioma with an increase in the age of the child. Among children over 1 year age, during the course of treatment, the greatest contribution the “hemangioma severity factor”, the influence of which leads to a decrease in the cosmetic effect of hemangioma treatment against the background of its high severity and an increase in the indicator of apoptosis inhibition of sFas. The influence of the “treatment efficacy” factor leads to a decrease in its cosmetic effect and an increase in the severity of the manifestations of hemangioma against the background of blocking the manifestations of apoptosis. Conclusions. When starting treatment of hemangioma in the early stages, the cosmetic effect increases significantly. A decrease in sFasL in the younger age group may indicate a decrease or absence of apoptosis processes, which is clinically expressed by active proliferation. An increase in sFas in the older age group (over a year old) may indicate a blockage of apoptosis processes and, as a consequence, a slow regression of hemangioma.

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“…[2][3][4][5] The diagnosis is basically clinical; Contrast MRI imaging evaluation is used to define the type, size, and extent of the lesion; 6 The treatment of a patient with IH is individualized, depending on factors such as size of lesion, location, presence of complications such as ulceration, risk of scarring or disfigurement, age of the patient, rate of growth or involution at the time of diagnosis, risks and benefits of administering the treatment. 7 We present the case of an infant with a diagnosis of deep IH in connection, treated with propranolol.…”

Section: Introductionmentioning

confidence: 99%

Propanolol as a treatment for deep infantile hemangioma: case report

Manuel¹,

Estuardo²,

Carlos³

et al. 2021

OGIJ

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Background: Infantile hemangiomas (IH) are common neoplasms composed of proliferating endothelial cells. The duration and the growth rate are variable; some grow very poorly, while others grow rapidly and at an unpredictable rate. Despite the relative frequency of IH and the possible severity of complications, there are currently no uniform treatment guidelines. Although most are not worrisome, about 12% of IHs are significantly complex; propranolol has been adopted as a treatment. Objective: Report a clinical case of lactanate with hemangioma treated with propranolol. Case report: A healthy newborn is presented, with the presence of small telangiectasias in the right hemicneck without association with obstetric trauma; of a healthy 31-year-old mother; During its evolution at 3 months of age, the area covered with telangiectasias turned deep blue and the growth of a protrusion began, ultrasound and angioresonance, showed soft tissues of the posterior cervical space a lobulated mass of 9.1x4.1x4.9cm in its longitudinal and transverse diameter respectively, diagnosing it as a deep hemangioma; which was treated with propanolol. Discussion: Asymptomatic newborns with infantile neck hemangiomas are clinically controlled for the first six months of life, 60% of them develop life-threatening airway symptoms; the identification of the hemangioma was due to its rapid growth and not due to the alteration of surrounding structures that put the well-being of the infant at risk. Regarding the application of Propranolol, its administration was immediately after its identification, to avoid future complications. Conclusion: administration of propranolol systemically eliminates the characteristic color and reduces the size of the hemangioma.

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Propranolol therapy in infantile hemangioma: correlation of age and duration of treatment to the outcomes

Cited by 5 publications

References 25 publications

Clinical Pharmacology of Propranolol in Infants and Children

Clinical Pharmacology of Propranolol in Infants and Children

Influence of Age and Morphological Features on the Clinical Manifestations and Treatment Efficacy of Hemangiomas in Children

Propanolol as a treatment for deep infantile hemangioma: case report

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