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Use of propranolol in infantile haemangioma among Chinese children
1Department of Paediatrics, United Christian Hospital, Kwun Tong, Hong Kong. kkchik@gmail.com
Insights
Oral propranolol effectively treats infantile haemangioma in Chinese children, showing minimal side effects. While recurrence can occur with rapid tapering, a second treatment course is successful.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Pharmacology
Background:
- Infantile haemangioma (IH) is a common vascular tumor in infants.
- The proliferating phase requires effective treatment to prevent complications.
- Propranolol has emerged as a key therapeutic agent for IH.
Purpose of the Study:
- To evaluate propranolol as a first-line or single-agent therapy for proliferating facial infantile haemangioma in Chinese children.
- To assess the efficacy and safety profile of oral propranolol in this specific population.
Main Methods:
- Retrospective study conducted at a regional hospital in Hong Kong.
- Inclusion criteria: Children aged 3 years or younger with facial haemangioma treated with oral propranolol between December 2008 and December 2009.
- 12 patients were analyzed, with clinical evaluation prior to treatment initiation.
Main Results:
- All 12 patients showed a clinical response within 7 days of starting propranolol.
- Complete resolution was observed in 41% of patients within 2-6 months.
- Two patients experienced recurrence after rapid tapering but responded to a second treatment course; minimal side effects like transient hypotension were noted.
Conclusions:
- Propranolol is a useful first-line or single-agent treatment for facial infantile haemangioma in Chinese children, with a favorable safety profile.
- Optimal treatment duration and tapering strategies require further investigation to minimize recurrence.
- Patients demonstrated good response to re-initiation of propranolol therapy if recurrence occurred.
Objective:
To describe the use of propranolol as first-line treatment or as single therapy to control the proliferating phase of infantile haemangioma in Chinese children.
Design:
Retrospective study.
Setting:
Regional hospital, Hong Kong.
Patients:
Children 3 years old or younger with facial haemangioma who took oral propranolol between 1 December 2008 and 1 December 2009.
Results:
There were 12 such patients, all of whom underwent prior clinical evaluation before starting the treatment. Ten patients had a solitary facial haemangioma and two had multiple haemangiomas. The mean age of symptom onset was 12 days. The mean age for starting propranolol treatment was 7 months, and in all cases a clinical response was observed within 7 days. Five (41%) of the patients had complete resolution 2 to 6 months after starting medication, at which time they were 5 to 12 months old. Two of them had a recurrence of the haemangioma within 8 weeks of stopping the drug, but responded to a second treatment course. In these two patients, the propranolol dosage had been tailed down rapidly and the therapy was of a shorter duration than in those without recurrence. The remaining seven patients are still taking propranolol and responding satisfactorily. Hypotension was observed in two patients, one of whom tolerated a lower dose and in the other, therapy was reinitiated at her older age. No serious side-effect was encountered in the remaining patients.
Conclusion:
Propranolol was useful as first-line or single-agent treatment of facial infantile haemangioma in Chinese children, and gave rise to minimal side-effects. Although recurrence of infantile haemangioma occurred after propranolol was tailed off rapidly after a relatively short duration, an optimal treatment duration and tapering schedule has not yet been defined. Nevertheless, patients responded well to second courses of propranolol therapy.
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