When to stop propranolol for infantile hemangioma

Abstract

There is no definitive conclusion regarding the optimal timing for terminating propranolol treatment for infantile hemangioma (IH). A total of 149 patients who underwent detailed color Doppler ultrasound examination were included in this study. The characteristics and propranolol treatment of all patients were summarized and analyzed. Patients were divided into two groups according to the lesion regression rate. Among the 149 patients, 38 were assigned to the complete regression group, and 111 were assigned to the partial regression group. The age at which propranolol treatment started, duration of follow-up after treatment discontinuation and rate of adverse events were not significantly different between the two groups. The duration of oral propranolol treatment was shorter in the complete regression group. The age at which propranolol was terminated was younger in the complete regression group, and this group had a lower recurrence rate. Propranolol is safe and effective for the treatment of IHs that require intervention, but it should be stopped at an appropriate time, which is determined primarily by the lesion regression rate after propranolol treatment. Ultrasound is helpful in determining when to stop propranolol for IH.

Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

“…stopped propranolol treatment when there was no obvious blood flow signal on ultrasound, resulting in no IH regrowth. Chang et al . insisted that propranolol can be stopped when patients are older than 1 year of age and achieve maximal reduction for more than 3 months.…”

“…26 Shi et al 26 stopped propranolol treatment when there was no obvious blood flow signal on ultrasound, resulting in no IH regrowth. Chang et al 27 insisted that propranolol can be stopped when patients are older than 1 year of age and achieve maximal reduction for more than 3 months. To measure the surface temperature of IH by using an infrared thermometer helps to predict their proliferative potential.…”

Prolonged growth of infantile hemangioma after pulsed dye laser and oral propranolol treatment

“…The decision to stop propranolol treatment is difficult, but ultrasonography may be helpful . Chang et al .…”

“…The decision to stop propranolol treatment is difficult, but ultrasonography may be helpful. 4 Chang et al 4 insisted that propranolol can be stopped when patients are older than 1 year of age and achieve maximal reduction for more than 3 months. Using an infrared thermometer to measure the surface temperature of IH helps to predict their proliferative potential.…”

Propranolol Suppresses Cobalt Chloride-Induced Hypoxic Proliferation in Human Umbilical Vein Endothelial Cells in vitro

“…Emerging studies have reported that propranolol could significantly inhibit the development of IH [12] Quantitative Real-Time PCR TRIzol reagent (Invitrogen, Carlsbad, CA, USA) was applied to extract total RNA according to the manufacturer's instructions. Using the High Capacity cDNA Reverse Transcription Kit (Applied Biosystems, Foster City, CA, USA), 1 μg RNA was reversetranscribed into cDNA To detect the mRNA levels of Caspase-3, B-cell lymphoma (Bcl-2) and Bcl-2-associated X protein (Bax), quantitative real-time-PCR was performed with SYBR Green master mix (Roche, Mannheim, Germany).…”