Retrospective follow up of gross motor development in children using propranolol for treatment of infantile haemangioma at <scp>S</scp>ydney Children's Hospital

Gonski, Kate; Wargon, Orli

doi:10.1111/ajd.12156

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Some published studies have evaluated gross motor development in children who received propranolol but did not evaluate cognition or memory function in depth. Gonski et al studied gross motor function by assessing six motor development milestones and found no gross motor anomalies in children treated with propranolol. Moyakine et al studied children 15 to 48 months of age using a three‐section scale assessing fine motor, adaptation, and personal social functioning; communication; and gross motor skills, with each involving a number of tasks that vary with age.…”

Section: Discussionmentioning

confidence: 99%

Study of Cognitive Function in Children Treated with Propranolol for Infantile Hemangioma

González-Llorente

Olmo-Benito

Muñoz-Ollero

et al. 2017

Pediatric Dermatology

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Section: Discussionmentioning

confidence: 99%

Study of Cognitive Function in Children Treated with Propranolol for Infantile Hemangioma

González-Llorente

Olmo-Benito

Muñoz-Ollero

et al. 2017

Pediatric Dermatology

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“…In 2 case series (with a total of 272 patients), gross motor delay was reported in 4.8% to 6.9%. 99,100 In contrast, a case series of 141 patients found psychomotor delay in only 1 child, and a controlled trial of 82 children found no increase in the rate of developmental concerns as assessed by the Ages and Stages Questionnaire. 101,102 Although these latter studies are reassuring, further prospective psychometric studies of children treated with oral propranolol for IHs may be warranted.…”

Section: Key Action Statement 3c (Table 14)mentioning

confidence: 93%

Clinical Practice Guideline for the Management of Infantile Hemangiomas

et al. 2019

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Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, because of their size or location, a significant minority of IHs are potentially problematic. These include IHs that may cause permanent scarring and disfigurement (eg, facial IHs), hepatic or airway IHs, and IHs with the potential for functional impairment (eg, periorbital IHs), ulceration (that may cause pain or scarring), and associated underlying abnormalities (eg, intracranial and aortic arch vascular abnormalities accompanying a large facial IH). This clinical practice guideline for the management of IHs emphasizes several key concepts. It defines those IHs that are potentially higher risk and should prompt concern, and emphasizes increased vigilance, consideration of active treatment and, when appropriate, specialty consultation. It discusses the specific growth characteristics of IHs, that is, that the most rapid and significant growth occurs between 1 and 3 months of age and that growth is completed by 5 months of age in most cases. Because many IHs leave behind permanent skin changes, there is a window of opportunity to treat higher-risk IHs and optimize outcomes. Early intervention and/or referral (ideally by 1 month of age) is recommended for infants who have potentially problematic IHs. When systemic treatment is indicated, propranolol is the drug of choice at a dose of 2 to 3 mg/kg per day. Treatment typically is continued for at least 6 months and often is maintained until 12 months of age (occasionally longer). Topical timolol may be used to treat select small, thin, superficial IHs. Surgery and/or laser treatment are most useful for the treatment of residual skin changes after involution and, less commonly, may be considered earlier to treat some IHs.

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“…Another concern is the observation by Gonski, who noted that 4 of 84 IH patients with oral propranolol for IH demonstrated a delay in unassisted walking. [56] In support of this, Langley summarizes many associated CNS effects of propranolol, including a meta-analysis of Lonergan, showing propranolol treatment negatively influences recall of emotional material. [57,58]We endorse the concern raised by Langley about the unknown significance of CNS effects resulting from propranolol use in IH patients during early developmental stages and/or for prolonged periods of therapy.…”

Section: Expert Opinionmentioning

confidence: 97%

Treatment of infantile hemangiomas: therapeutic options in regard to side effects and adverse events – a review of the literature

Raphaël

Breur

Vlasveld

et al. 2016

Expert Opinion on Drug Safety

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Introduction: While options for treatment strategies for infantile hemangiomas (IH) are numerous, evidence-based information about agents, optimal dosage, adverse effects, treatment modality, pretreatment and treatment strategies remain limited. Areas covered: To evaluate side effects and adverse events of medical treatment in children with infantile hemangioma, a comprehensive review of the literature was performed to provide information for daily practice. In total 254 studies were retrieved from medical databases and comprised 10,022 patients divided into 5 different treatment groups. Information about working mechanism, side effects and adverse events of therapies used as a single agent for IH are discussed and evaluated according to information from pharmacotherapeutic databases. Randomized controlled trials have only scarcely been performed for the many therapeutic options reported for IH. Short-and long-term side effects and adverse events, have not been systematically studied. Subsequently information about the medical treatment options and pharmacotheraputic databases for therapy in children with IH are incomplete. Expert opinion: From the many therapeutic options, propranolol is the first-line approach for IH, predominantly based on clinical observation, efficacy and tolerability in the short-term. The unsolved ravels of possible short and long-term adverse events of propranolol used during early developmental stages of children need thorough review.

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Retrospective follow up of gross motor development in children using propranolol for treatment of infantile haemangioma at Sydney Children's Hospital

Cited by 12 publications

References 11 publications

Study of Cognitive Function in Children Treated with Propranolol for Infantile Hemangioma

Study of Cognitive Function in Children Treated with Propranolol for Infantile Hemangioma

Clinical Practice Guideline for the Management of Infantile Hemangiomas

Treatment of infantile hemangiomas: therapeutic options in regard to side effects and adverse events – a review of the literature

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