Propranolol Treatment for Hemangioma of Infancy: Risks and Recommendations

Lawley, Leslie P.; Siegfried, Elaine C.; Todd, Jane L.

doi:10.1111/j.1525-1470.2009.00975.x

Cited by 252 publications

(223 citation statements)

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“…Diagnosis was based on the typical appearance of the lesion in all cases of superficial periocular IHs, [12][13][14][15][16][17]19 and in one case of orbital lesion, 13 where a right anterior orbitotomy was performed and the appearance of the lesion was typical of a capillary haemangioma. Imaging in the form of computerized tomography or magnetic resonance imaging was performed to diagnose all intraconal masses (11 cases in this review).…”

Section: Patient Demographicsmentioning

confidence: 99%

The use of propranolol in the management of periocular capillary haemangioma—a systematic review

Cornish

Reddy

2011

Eye

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Capillary haemangioma or infantile haemangioma (IH) is the most common congenital vascular tumour in the periocular region. Several treatment modalities have been documented, with variable degree of success. Propranolol has recently been reported to be an effective and safe alternative. The aim of this systematic review is to examine the evidence base for the use of propranolol administered orally in the management of periocular capillary haemangioma, and use this information to guide future research. A systematic review of literature was carried out by two independent reviewers using the search strategies highlighted below. A total of 100 cases of oral propranolol use in periorbital or orbital capillary haemangiomas have been documented in the literature. Of the 85 cases that had details of previous treatment, it was used as first-line treatment in 50 (58.8%). The commonest dose used was 2 mg/kg/day. Adverse events were documented in one-third of cases; in most cases these were minor. Improvement or complete resolution of the lesions occurred in 96% of cases. Recurrence was noted in one-fifth of cases. Propranolol has shown a lot of promise in the therapy of IH and further research in the form of properly designed randomized trials is certainly warranted. Treatment guidelines based on literature available to date is included in this review.

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Section: Patient Demographicsmentioning

confidence: 99%

The use of propranolol in the management of periocular capillary haemangioma—a systematic review

Cornish

Reddy

2011

Eye

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“…A lower dosage is recommended for children younger than 3 months of age, due to the increased risk of hypoglycemia. 7 Clinical presentation and natural history of hemangiomas are variable. An expectant conduct is acceptable in the less serious cases; however, intervention is needed when there is significant esthetic or functional compromise.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography of the abdomen, ecocardiography and cranial angiotomography should be used to prevent these complications. 7 Heart rate, blood pressure, capillary glycemia and electrocardiogram should be evaluated before and during treatment. The dosage of 2 mg/kg/day should be gradually introduced, starting with 0.17 mg/kg every 8 hours and gradually increasing up to a 0.67 mg/kg/dose, equivalent to 2mg/kg/day.…”

Section: Discussionmentioning

confidence: 99%

“…The lesions affecting the periorbital area, midface region, airways, cutaneous folds, anogenital areas and regions at risk for ulceration, dysfunction or disfigurement require treatment. 6,7 An attempt is also made to prevent or reverse complications that threaten organ life or function. 8 Lesion size and location, age of the patient, hemangioma growth phase and psychosocial implications to the patient and parents should be considered.…”

Section: Introductionmentioning

confidence: 99%

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Hemangioma infantil tratado com propranolol

Bonini

Bellodi

Souza

2011

An. Bras. Dermatol.

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Resumo:Infantile hemangioma or hamangioma of infancy is the most common tumor in children, with great variability of presentation. Most cases resolve spontaneously and treatment is usually indicated for specific cases where injury has a high rate of morbidity or disfigurement after regression. The treatment is based on the use of systemic corticosteroids, which can also be used topically or by intralesional injections. Propranolol has been used recently as a new therapeutic option for the treatment of hemangiomas, with satisfactory, permanent results and fewer adverse effects than corticosteroids. This is a report of the case where a child presenting extensive periorbital and frontoparietal hemangioma was treated with propranolol. Keywords: Adrenal cortex hormones; Hemangioma; Orbit; Propranolol Abstract: O hemangioma infantil é o tumor mais comum da infância, com grande variabilidade de apresentação clínica. A maioria das lesões regride espontaneamente e o tratamento está indicado para casos específicos que possam gerar ulceração, disfunção ou desfiguração. O tratamento baseia-se, principalmente, no uso de corticosteroides, seja por via sistêmica, tópica ou intralesional. Recentemente, o propranolol foi descrito como nova opção terapêutica para os hemangiomas, com resultados satisfatórios, permanentes e menos efeitos indesejáveis que os corticosteroides. É relatado o caso de uma criança com hemangioma periorbital e frontoparietal extenso, tratado com propranolol.

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“…Unfortunately, current therapeutic approaches have limited success and significant adverse effects that limit their use. 12---16 Since Léauté-Labrèze's accidental observation 17 of the anti-proliferative effect of propranolol on infantile hemangiomas, propranolol has become increasingly popular 18,19 as a successful therapeutic option, with fewer side effects than other treatments.…”

Section: Introductionmentioning

confidence: 99%

The role of propranolol in the treatment of infantile hemangioma

Laranjo

Costa

Paramés

et al. 2014

Revista Portuguesa de Cardiologia

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Introduction: Infantile hemangioma (IH) is one of the most common childhood tumors. There are various medical or surgical therapeutic options, all with suboptimal results. Recently, the successful use of propranolol for involution of IH was described. We report the results of a single-center experience with this therapeutic option. Objective: To prospectively assess the efficacy and safety of propranolol in children with infantile hemangioma. Methods:We performed a prospective analysis of clinical data of all patients with IH referred to a pediatric cardiology center for baseline cardiovascular assessment prior to propranolol therapy. Propranolol was given at a starting dose of 1 mg/kg/day and titrated to a target dose of 2---3 mg/kg/day according to clinical response. Efficacy was assessed through a photographbased severity scoring scale. Safety was assessed by collecting data regarding significant side effects. Results: Starting in 2010, 30 patients (15 female) were referred for propranolol treatment of IH, at a median age of six months (1---63 months). The mean target propranolol dose was 2.8 mg/kg/day, with a mean duration of therapy of 12 months. All patients experienced significant reduction of IH size and volume. There were no side effects. Conclusions: In our experience propranolol appears to be a useful and safe treatment option for severe or complicated IH, achieving a rapid and significant reduction in their size. No adverse effects were observed, although until larger clinical trials are completed, potential adverse events should be borne in mind and consultation with local specialists is recommended prior to initiating treatment. PALAVRAS-CHAVE Hemangioma infantil; Propranolol O papel do propranolol no tratamento dos hemangiomas em idade pediátrica ResumoIntrodução: Os hemangiomas são a lesão tumoral cutânea mais frequente em idade pediátrica. Até ao momento todas as opções terapêuticas (tanto médicas como cirúrgicas) têm resultados sub-ótimos. Recentemente, foi descrita a utilização de propranolol para tratamento dos hemangiomas. Relatamos os resultados da nossa experiência com esta opção terapêutica. Objetivo: Avaliação prospetiva da eficácia e segurança de propranolol em crianças com hemangioma infantil. Métodos: Avaliação prospetiva de todos os doentes com hemangioma referenciados para avaliação cardiovascular prévia ao início de terapêutica com propranolol. O propranolol foi administrado numa dose inicial de 1 mg/kg/dia e titulada para uma dose alvo de 2---3 mg/kg/dia, de acordo com a resposta clínica. A eficácia foi avaliada através de uma escala fotográfica. A segurança foi avaliada através da recolha de dados sobre os efeitos secundários significativos. Resultados: Desde 2010, 30 crianças (15 do sexo feminino) com hemangiomas foram referenciados para avaliação cardiovascular prévia ao início de terapêutica beta-bloqueante, com uma idade média de 6 meses (1-63 meses). A dose alvo média atingida foi de 2,8 mg / kg / dia, com uma duração média de tratamento de 12 meses. Em todos os doe...

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Propranolol Treatment for Hemangioma of Infancy: Risks and Recommendations

Cited by 252 publications

References 11 publications

The use of propranolol in the management of periocular capillary haemangioma—a systematic review

The use of propranolol in the management of periocular capillary haemangioma—a systematic review

Hemangioma infantil tratado com propranolol

The role of propranolol in the treatment of infantile hemangioma

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